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REVIEW
published: 10 May 2016
doi: 10.3389/fpsyg.2016.00687
Edited by:
Xiaochu Zhang,
University of Science and Technology
of China, China
Reviewed by:
Ricardo De Oliveira-Souza,
Federal University of the State of Rio
de Janeiro, Brazil
Sabine Vollstädt-Klein,
Heidelberg University, Germany
*Correspondence:
Lucy L. Brown
lucy.brown@einstein.yu.edu
Specialty section:
This article was submitted to
Cognitive Science,
a section of the journal
Frontiers in Psychology
Received: 08 February 2016
Accepted: 25 April 2016
Published: 10 May 2016
Citation:
Fisher HE, Xu X, Aron A and Brown LL
(2016) Intense, Passionate, Romantic
Love: A Natural Addiction? How
the Fields That Investigate Romance
and Substance Abuse Can Inform
Each Other. Front. Psychol. 7:687.
doi: 10.3389/fpsyg.2016.00687
Intense, Passionate, Romantic Love:
A Natural Addiction? How the Fields
That Investigate Romance and
Substance Abuse Can Inform Each
Other
Helen E. Fisher1, Xiaomeng Xu2, Arthur Aron3and Lucy L. Brown4*
1The Kinsey Institute, Indiana University, Bloomington, IN, USA, 2Department of Psychology, Idaho State University,
Pocatello, ID, USA, 3Department of Psychology, The State University of New York Stony Brook, Stony Brook, NY, USA,
4Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Individuals in the early stage of intense romantic love show many symptoms of
substance and non-substance or behavioral addictions, including euphoria, craving,
tolerance, emotional and physical dependence, withdrawal and relapse. We have
proposed that romantic love is a natural (and often positive) addiction that evolved
from mammalian antecedents by 4 million years ago as a survival mechanism to
encourage hominin pair-bonding and reproduction, seen cross-culturally today in Homo
sapiens. Brain scanning studies using functional magnetic resonance imaging support
this view: feelings of intense romantic love engage regions of the brain’s “reward
system,” specifically dopamine-rich regions, including the ventral tegmental area, also
activated during drug and/or behavioral addiction. Thus, because the experience of
romantic love shares reward pathways with a range of substance and behavioral
addictions, it may influence the drug and/or behavioral addiction response. Indeed, a
study of overnight abstinent smokers has shown that feelings of intense romantic love
attenuate brain activity associated with cigarette cue-reactivity. Could socially rewarding
experiences be therapeutic for drug and/or behavioral addictions? We suggest that “self
expanding” experiences like romance and expanding one’s knowledge, experience and
self-perception, may also affect drug and/or behavioral addiction behaviors. Further,
because feelings of romantic love can progress into feelings of calm attachment, and
because attachment engages more plastic forebrain regions, there is a rationale for
therapies that may help substance and/or behavioral addiction by promoting activation
of these forebrain systems through long-term, calm, positive attachments to others,
including group therapies. Addiction is considered a negative (harmful) disorder that
appears in a population subset; while romantic love is often a positive (as well
as negative) state experienced by almost all humans. Thus, researchers have not
categorized romantic love as a chemical or behavioral addiction. But by embracing
data on romantic love, it’s classification as an evolved, natural, often positive but
also powerfully negative addiction, and its neural similarity to many substance and
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Fisher et al. Romantic Love As an Addiction
non-substance addictive states, clinicians may develop more effective therapeutic
approaches to alleviate a range of the addictions, including heartbreak–an almost
universal human experience that can trigger stalking, clinical depression, suicide,
homicide, and other crimes of passion.
Keywords: romantic love, addiction, ventral tegmental area, caudate
INTRODUCTION
We propose that romantic love is a natural addiction (Frascella
et al., 2010) that evolved from mammalian antecedents (Fisher
et al., 2006). Brain scanning studies show that feelings of intense
romantic love engage regions of the brain’s “reward system,”
specifically dopamine pathways associated with energy, focus,
learning, motivation, ecstasy, and craving, including primary
regions associated with substance addiction, such as the ventral
tegmental area (VTA), caudate and accumbens (Breiter et al.,
1997;Bartels and Zeki, 2000, 2004;Fisher et al., 2003, 2005, 2006,
2010;Aron et al., 2005;Ortigue et al., 2007;Acevedo et al., 2011;
Xu et al., 2011). Several of these reward regions of the mesolimbic
system associated with romantic love and substance addiction
are also activated during non-substance or behavioral addiction,
including viewing images of appealing food (Wang et al., 2004),
shopping (Knutson et al., 2007), playing video games (Hoeft
et al., 2008), and gambling (Breiter et al., 2001). Indeed, several
researchers have taken the position that “addiction is a disease
of the reward system” (Rosenberg and Feder, 2014). Moreover,
men and women who are passionately in love and/or rejected in
love show the basic symptoms of substance-related and gambling
addiction listed in the Diagnostic and Statistical Manual of
Mental Disorders-5, including craving, mood modification,
tolerance, emotional and physical dependence and withdrawal.
Relapse is also a common problem for those suffering with a
substance and/or behavioral addiction, as well as among rejected
lovers.
Because passionate romantic love is regularly associated with
a suite of traits linked with all addictions, several psychologists
have come to believe that romantic love can potentially become
an addiction (Peele, 1975;Tennov, 1979;Hunter et al., 1981;
Halpern, 1982;Schaef, 1989;Griffin-Shelley, 1991;Mellody
et al., 1992). However, many define addiction as a pathological,
problematic disorder (Reynaud et al., 2010); and because
romantic love is a positive experience under many circumstances
(i.e., not harmful), researchers remain hesitant to officially
categorize romantic love as an addiction. But even when romantic
love can’t be regarded as harmful, it is associated with intense
craving and can impel the lover to believe, say and do dangerous
and inappropriate things.
All forms of substance abuse, including alcohol, opioids,
cocaine, amphetamines, cannabis, and tobacco activate reward
pathways (Breiter et al., 1997;Melis et al., 2005;Volkow et al.,
2007;Frascella et al., 2010;Koob and Volkow, 2010;Diana, 2013),
as do several of the behavioral addictions (see Cuzen and Stein,
2014); and several of these same reward pathways are also found
to be activated among men and women who are happily in
love, as well as those rejected in love (Bartels and Zeki, 2000,
2004;Fisher et al., 2003, 2010;Aron et al., 2005;Ortigue et al.,
2007;Acevedo et al., 2011;Xu et al., 2011). So regardless of
its official diagnostic classification, we propose that romantic
love should be considered as an addiction (Fisher, 2004, 2016):
a positive addiction when one’s love is reciprocated, non-toxic
and appropriate, and a negative addiction when one’s feelings of
romantic love are socially inappropriate, toxic, not reciprocated
and/or formally rejected (Fisher, 2004;Frascella et al., 2010).
Romantic love may have evolved at the basal radiation of
the hominin clade some 4.4 million years ago in conjunction
with the evolution of serial social monogamy and clandestine
adultery–hallmarks of the human reproductive strategy (Fisher,
1998, 2004, 2011, 2016). Its purpose may have been to motivate
our forebears to focus their mating time and energy on a single
partner at a time, thus initiating the formation of a pair-bond to
rear their young together as a team (Fisher, 1992, 1998, 2004,
2011, 2016;Fisher et al., 2006;Fletcher et al., 2015). Thus, as
products of human evolution, the neural systems for romantic
love and mate attachment could be considered as survival systems
among humans.
ADDICTION-LIKE BEHAVIORS IN EARLY
STAGE, PASSIONATE LOVERS:
EUPHORIA, OBSESSION, RISKY
BEHAVIOR
Men and women in the early stage of intense passionate romantic
love express many of the basic traits associated with all addiction
(Tennov, 1979;Liebowitz, 1983;Hatfield and Sprecher, 1986;
Harris, 1995;Lewis et al., 2000;Meloy and Fisher, 2005;American
Psychiatric Association, 2013). Like all addicts, they focus on
their beloved (salience); and they yearn for the beloved (craving).
They feel a “rush” of exhilaration when seeing or thinking about
him or her (euphoria/intoxication). As their relationship builds,
the lover seeks to interact with the beloved more and more
frequently (tolerance). If the beloved breaks off the relationship,
the lover experiences the common signs of drug withdrawal,
too, including protest, crying spells, lethargy, anxiety, insomnia,
or hypersomnia, loss of appetite or binge eating, irritability
and chronic loneliness. Like most addicts, rejected lovers also
often go to extremes, even sometimes doing degrading or
physically dangerous things to win back the beloved (Meloy,
1998;Lewis et al., 2000;Meloy and Fisher, 2005). Romantic
partners are willing to sacrifice, even die for the other. Romantic
jealousy is particularly dangerous and can lead to major crimes
including homicide, and/or suicide. Lovers also relapse the way
drug addicts do: long after the relationship is over, events,
people, places, songs, and/or other external cues associated with
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their abandoning sweetheart can trigger memories and initiate
renewed craving, obsessive thinking and/or compulsive calling,
writing or showing up in hopes of rekindling the romance–
despite what they suspect may lead to adverse consequences.
Passionate lovers also express strong sexual desire for the
beloved; yet their yearning for emotional union tends to
overshadow their craving for sexual union with him or her
(Tennov, 1979). Most characteristic, the lover thinks obsessively
about the beloved (intrusive thinking). Besotted lovers may
also compulsively follow, incessantly call, write or unexpectedly
appear, all in an effort to be with their beloved day and night
(Tennov, 1979;Lewis et al., 2000;Meloy and Fisher, 2005).
Paramount to this experience is intense motivation to win
him or her. All these behaviors are common to those with
substance addictions. However, not everyone exhibits these types
of behaviors after a breakup, just as not everyone who uses
a substance exhibits dependency and withdrawal effects (e.g.,
Shiffman, 1989;Shiffman et al., 1995;Shiffman and Paty, 2006;
Haney, 2009).
THE BRAIN SYSTEMS ASSOCIATED
WITH ROMANTIC LOVE
Neuroimaging studies of intense, passionate romantic love reveal
the physiological underpinnings of this universal or near-
universal human experience, and they all show activation of the
VTA (Fisher et al., 2003, 2010;Bartels and Zeki, 2004;Aron
et al., 2005;Ortigue et al., 2007;Zeki and Romaya, 2010;Acevedo
et al., 2011;Xu et al., 2011). In our first experiment (Fisher et al.,
2003;Aron et al., 2005), we used functional magnetic resonance
imaging (fMRI) to study 10 women and 7 men who had recently
fallen intensely and happily in love. All scored high on the
Passionate Love Scale (Hatfield and Sprecher, 1986), a self-report
questionnaire that measures the intensity of romantic feelings; all
participants also reported that they spent more than 85% of their
waking hours thinking of their beloved.
Participants alternately viewed a photograph of their
sweetheart and a photograph of a familiar individual,
interspersed with a distraction-attention task. Group activation
occurred in several regions of the brain’s reward system,
including the VTA and caudate nucleus (Fisher et al., 2003;Aron
et al., 2005), regions associated with pleasure, general arousal,
focused attention and motivation to pursue and acquire rewards
and mediated primarily by dopamine system activity (Delgado
et al., 2000;Schultz, 2000;Elliott et al., 2003). These regions of
the reward system are directly associated with addiction in many
studies of drugs of abuse (Breiter et al., 1997;Panksepp et al.,
2002;Melis et al., 2005;Volkow et al., 2007;Frascella et al., 2010;
Koob and Volkow, 2010;Diana, 2013) and behavioral addictions
(see Cuzen and Stein, 2014).
These data from several studies indicate that individuals who
are happily in the early stages of passionate love express activity
in neural regions associated with drug and some behavioral
addictions.
There is also a difference between “wanting” and
“liking/pleasure” suggested by Berridge et al. (2009). As in
substance addiction, “wanting” the romantic partner is different
from “liking” a pretty face and finding pleasure in a beautiful
sight. We found that brain activation to an attractive face
(“liking”) was different from activation to the beloved partner
(“wanting”): the former activated the left VTA, while the
latter activated the right VTA (Aron et al., 2005). The result
suggests the addictive aspects of romantic love are mediated
through the right VTA, and that pleasure, or “liking” is
different.
ADDICTION-LIKE BEHAVIORS
ASSOCIATED WITH ROMANTIC
REJECTION: CRAVING, RELAPSE AND
DESTRUCTIVE BEHAVIOR
Cross-culturally, few men or women avoid suffering from
romantic rejection at some point across their lives. In one
American college community, 93% of both sexes queried
reported that they had been spurned by someone whom they
passionately loved; 95% reported they had rejected someone who
was deeply in love with them (Baumeister et al., 1993). Romantic
rejection can cause a profound sense of loss and negative affect
(although this is not always the case e.g., Lewandowski and
Bizzoco, 2007). Like many addictions, romantic rejection can
also jeopardize one’s health, because abandonment rage stresses
the heart, raises blood pressure and suppresses the immune
system (Dozier, 2002). It can also induce clinical depression,
and in extreme cases lead to suicide and/or homicide. Some
broken-hearted lovers even die from heart attacks or strokes
caused by their depression (Rosenthal, 2002). The suite of
negative phenomena associated with rejection in love, including
protest, the stress response, frustration attraction, abandonment
rage, and jealousy, in conjunction with craving and withdrawal
symptoms, most likely also contribute to the high worldwide
incidence of crimes of passion (see Meloy, 1998;Meloy and
Fisher, 2005).
One pathology is also regularly associated with romantic love,
stalking. There are two common types of stalkers: those who
sustain pursuit of a former sexual/romantic intimate who has
rejected them; and those who pursue a stranger or acquaintance
who has failed to return the stalker’s romantic overtures (Meloy
and Fisher, 2005). In both cases, the stalker exhibits several
of the characteristic components of all addictions, including
focused attention on the love object, increased energy, following
behaviors, and obsessive thinking about and impulsivity directed
toward the victim, suggesting that stalking also activates aspects
of the reward system in the brain (Meloy and Fisher, 2005) and
may be akin to addiction. Another pathology, de Clerambault’s
syndrome, also known as erotomania, has not been associated
with addiction. This syndrome is characterized by the patient’s
delusional notion that another person is madly in love with
him or her; generally it is a young woman who believes
that she is the love object of a man of higher social or
professional standing. But because this syndrome has no direct
association with reward system activity and may be a form
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of paranoid schizophrenia or other delusional disorder (Jordan
and Howe, 1980;Kopelman et al., 2008) rather than addiction,
discussion of this syndrome is beyond the scope of this
paper.
It appears, however, as if evolution has overdone the negative
response to romantic abandonment. But romantically rejected
individuals have wasted precious courtship time and metabolic
energy; they have lost essential economic and financial resources;
their social alliances have been jeopardized; their daily rituals
and habits have been altered; they may have lost property; and
they have most likely experienced damage to their personal
happiness, self-esteem and reputation (see Leary, 2001;Fisher,
2004). Most important, rejected lovers of reproductive age are
likely to have lost breeding opportunities or a parenting partner
for the offspring they have already produced—forms of reduced
future genetic viability (Fisher, 2004). Thus, romantic rejection
can have severe social, psychological, economic, and reproductive
consequences.
ROMANTIC REJECTION ALSO
ACTIVATES BRAIN REGIONS
ASSOCIATED WITH DRUG CRAVING
To identify some of the neural systems associated with this
natural craving state elicited by romantic rejection, we used
fMRI to study 10 women and 5 men who had recently been
rejected by a partner, but reported that they were still intensely
“in love” (Fisher et al., 2010). The average length of time since the
initial rejection and the participants’ enrollment in the study was
63 days. All scored high on the Passionate Love Scale (Hatfield
and Sprecher, 1986); all reported that they spent most of their
waking hours thinking about the person who rejected them;
and all yearned for their abandoning partner to return to the
relationship.
Participants alternately viewed a photograph of their rejecting
partner and a photograph of a familiar, emotionally neutral
individual, interspersed with a distraction-attention task. Their
responses while looking at their rejecter in the scanner included
feelings of romantic passion, despair, joyous, and painful
memories, rumination about why this had happened, and mental
assessments of their gains and losses from the experience. Brain
activations coupled with viewing the rejecter occurred in several
regions of the brain’s reward system. Included were: the VTA
associated with feelings of intense romantic love; the ventral
pallidum associated with feelings of attachment; the insular
cortex and the anterior cingulate associated with physical pain
and the distress associated with physical pain; and the nucleus
accumbens and orbitofrontal/prefrontal cortex associated with
assessing one’s gains and losses, as well as craving and addiction
(Fisher et al., 2010). Activity in several of these brain regions has
been correlated with craving for cocaine and other drugs of abuse
(Melis et al., 2005;Frascella et al., 2010;Koob and Volkow, 2010;
Diana, 2013).
To understand the impact of right VTA activations associated
with happy early stage relationships and romantic rejection, it
is important to consider both “liking” (hedonic impact) and
“wanting” (e.g., incentive salience) aspects of reward. That is,
approach behavior and desired interaction with a person or a
substance may or may not involve actual pleasurable experiences.
In the context of addiction, it is often the case that a strong desire
for the substance or a behavioral addiction, approach motivation
and use, occurs even when the stimuli no longer provides a “high”
and the reward-seeking behavior is associated with negative
outcomes (e.g., the addiction is detrimental to the individual’s
health, career, social relationships etc.). Those who are rejected
in love still “want” the ex-partner and experience approach
motivation (e.g., desiring to contact the ex-partner) even when
contact with the ex may be accompanied by negative outcomes
and not pleasurable (e.g., experiences of sadness and pain).
A distinction between hedonic impact and incentive salience has
been explored in animal studies (Berridge et al., 2009). We also
found that looking at the partners face activated the right VTA
while left VTA activation correlated with the attractiveness of
faces in the study (Aron et al., 2005).
ATTACHMENT
For those who stay in a relationship beyond the early stage,
intense romantic phase, an important second constellation of
feelings sets in, associated with attachment (Acevedo et al., 2011).
In our studies of individuals who are happily in love (Fisher
et al., 2003;Aron et al., 2005), we found that those in longer
partnerships (8–17 months as opposed to 1–8 months) began to
show activity in the ventral pallidum, associated with attachment
in animal studies (Insel and Young, 2001), while continuing to
show activity in the VTA and caudate nucleus associated with
passionate romantic love. Thus, with time, feelings of attachment
begin to accompany feelings of passionate romantic love (Fisher,
2004;Acevedo et al., 2011). Working in conjunction, these two
basic neural systems for romantic love and attachment may
constitute the biological foundation of human pair-bonding—
and provide the context for the evolution of love addictions
(Insel, 2003;Burkett and Young, 2012;Fisher, 2016).
EVOLUTION OF ROMANTIC LOVE AND
ATTACHMENT
It has been proposed that the neural systems associated with
feelings of intense romantic love and partner attachment evolved
in conjunction with the evolution of the human predisposition
for pair-bonding, serving as mechanisms to stimulate mate choice
and motivating individuals to remain with a mate long enough to
breed and rear their offspring through infancy as a team (Fisher,
2004, 2011, 2016;Fisher et al., 2006). This hypothesis suggests
that the neural systems for romantic love and attachment are
survival systems with evolutionary roots (Frascella et al., 2010).
Pair-bonding is a hallmark of humanity. Data from the
Demographic Yearbooks of the United Nations on 97 societies
canvassed in the 1980s indicate that approximately 93.1% of
women and 91.8% of men in that decade married by age 49
(Fisher, 1989, 1992). Worldwide, marriage rates have declined
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since then; but today 85 to 90% of men and women in the
United States are projected to marry (Cherlin, 2009). Cross-
culturally, most individuals are monogamous; they form a sexual
and socially sanctioned partnership with one person at a time.
Polygyny (many females) is permitted in 84% of human societies;
but in the vast majority of these cultures, only 5 to 10% of
men actually have several wives simultaneously (Van den Berghe,
1979;Frayser, 1985). Moreover, because polygyny in humans
is regularly associated with rank and wealth, monogamy (i.e.,
pair-bonding) may have been even more prevalent in the pre-
horticultural, unstratified societies of our long human hunting-
gathering past (Daly and Wilson, 1983), when the neural systems
for intense early stage romantic love and partner attachment most
likely evolved.
Data suggest that the human predisposition for pair-bonding
(often preceded by romantic attraction) also has a biological
basis. The investigation of human attachment began with Bowlby
(1969, 1973) and Ainsworth et al. (1978) who proposed that,
to promote the survival of the young, primates have evolved
an innate attachment system designed to motivate infants to
seek comfort and safety from their primary caregiver, generally
the mother. Since these early studies, extensive research has
been done on the behaviors, feelings and neural mechanisms
associated with this attachment system in adult humans and
other animals (Fraley and Shaver, 2000;Eisenberger et al., 2003;
Panksepp, 2003a,b;Bartels and Zeki, 2004;MacDonald and Leary,
2005;Tucker et al., 2005;Noriuchi et al., 2008). Currently,
researchers believe that this biologically based attachment system
remains active throughout the human life course, serving as the
foundation for attachment between pair-bonded partners for the
purpose of raising offspring (Hazan and Shaver, 1987;Hazan and
Diamond, 2000).
Pair-bonding could have evolved at any point in hominin
evolution; and with it, various love addictions (Fisher, 2016).
However, two lines of data suggest that the neural circuitry for
human pair-bonding may have evolved at the basal radiation of
the hominin stock (Fisher, 1992, 2011, 2016), in tandem with the
hominin adaptation to the woodland/savannah eco-niche some
time prior to 4 million years B.P. Ardipithecus ramidus, currently
dated at 4.4 million years B.P., displays several physical traits that
have been linked with pair-bonding in many species (Lovejoy,
2009); so Lovejoy (2009) proposes that human monogamy had
evolved by this time. Anthropologists have also re-measured
Australopithecus afarensis fossils for skeletal variations; and they
report that by 3.5 million years B.P. hominins exhibited roughly
the same degree of sexual dimorphism in several physical traits
that the sexes exhibit today. Thus, some have proposed that
these hominins were “principally monogamous” (Reno et al.,
2003).
The emergence of bipedalism may have been a primary
factor in the evolution of the neural circuitry for hominin
pair-bonding (Fisher, 1992, 2011, 2016) and the concomitant
evolution of romantic love (and possibly attachment) addiction.
While foraging and scavenging in the woodland/savannah eco-
niche, bipedal Ardipithecine females were most likely obliged to
carry infants in their arms instead of on their backs, thus needing
the protection and provisioning of a mate while they transported
nursing young. Meanwhile, Ardipithecine males may have had
considerable difficulty protecting and providing for a harem of
females in this open woodland/savannah eco-niche. But a male
could defend and provision a single female with her infant as
they walked near one another, within the vicinity of the larger
community.
So the exigencies of bipedalism in conjunction with hominin
expansion into the woodland/savannah eco-niche may have
pushed Ardipithecines over the “monogamy threshold,” selecting
for the neural system for attachment to a pair-bonded partner.
And along with the evolution of pair-bonding and the neural
system for attachment may have emerged the brain system for
intense positive romantic addiction—serving to motivate males
and females to focus their mating energy on a single partner and
remain together long enough to trigger feelings of attachment
necessary to initiate and complete their co-parenting duties of
highly altricial young (Fisher, 1992, 2004, 2011, 2016).
HUMAN ROMANTIC LOVE AS A
DEVELOPED FORM OF A MAMMALIAN
COURTSHIP MECHANISM
Considerable data suggest that the human brain system for
romantic love arose from mammalian antecedents. Like
humans, all birds and mammals exhibit mate preferences; they
focus their courtship energy on favored potential mates and
disregard or avoid others (Fisher, 2004;Fisher et al., 2006).
Moreover, most of the basic traits associated with human
romantic love are also characteristic of mammalian courtship
attraction, including increased energy, focused attention,
obsessive following, affiliative gestures, possessive mate guarding,
goal-oriented behaviors and motivation to win and keep a
preferred mating partner for the duration of one’s species-specific
reproductive and parenting needs (Fisher et al., 2002, 2006;
Fisher, 2004).
The brain system for human romantic love shows biological
similarities with mammalian neural systems for courtship
attraction. When a female laboratory–maintained prairie vole
is mated with a male, she forms a distinct preference for him,
associated with a 50% increase of dopamine in the nucleus
accumbens (Gingrich et al., 2000). When a dopamine antagonist
is injected into the nucleus accumbens, the female no longer
prefers this partner; and when a female is injected with a
dopamine agonist, she begins to prefer the conspecific who
is present at the time of the infusion, even if she has not
mated with this male (Wang et al., 1999;Gingrich et al.,
2000). An increase in the activities of central dopamine is also
associated with courtship attraction in female sheep (Fabre-
Nys et al., 1997). In male rats, increased striatal dopamine
release has also been shown in response to the presence of a
receptive female rat (Robinson et al., 2002;Montague et al.,
2004).
Because human romantic love shares many behavioral and
biological characteristics with mammalian courtship attraction,
it is likely that human romantic love is a developed form
of this mammalian neural courtship mechanism (Fisher, 1998,
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2004, 2011,2016;Fisher et al., 2006). However, in most species
courtship attraction is brief, lasting only minutes, hours, days,
or weeks; while in humans, intense, early stage romantic love
can last 12–18 months (Marazziti et al., 1999) or much longer
(Acevedo et al., 2011). So in early hominin prehistory, activity
in this mammalian neural system for courtship attraction
may have become intensified and prolonged as pair-bonding
evolved, eventually becoming the positive (or negative) romantic
addictions experienced by men and women cross-culturally
today.
ROMANTIC LOVE MAY ACT AS A
REWARD REPLACEMENT FOR OTHER
ADDICTIONS
High quality social relationships (including romantic
relationships) can be extremely beneficial to those recovering
from an addiction (e.g., Hänninen and Koski-Jännes, 1999).
One potential mechanism for this benefit comes from the
therapeutic approach to drug addiction of reward replacement.
That is, when quitting one addictive substance or behavior,
the addicted individual replaces this addiction with another
form of rewarding behavior, often without prompting from an
outside source, such as a clinician (Donovan, 1988;Marks, 1990;
DiNardo and Lemieux, 2001;Haylett et al., 2004;Alter et al.,
2006). Because of this, clinicians who treat addictions are known
to effectively engage patients in new reinforcers (see Bickel et al.,
2014), specifically healthy replacement reinforcers such as sports
activities, new hobbies and more or new social interactions (e.g.,
Vaillant, 1983;Salvy et al., 2009;Liu et al., 2011).
Could early stage romance provide a replacement reward for
those engaged in substance abuse (or a behavioral addiction)? To
explore this question, Xu et al. (2012) put 18 Chinese overnight
nicotine-deprived smokers who had just fallen madly in love
into a brain scanner, using fMRI. These men and women looked
at side-by-side photos, one of a hand holding either a lighted
cigarette (cue) or a pencil (control) and one of their newly
beloved or a familiar acquaintance (non-smokers so they were not
cigarette-cues). Among those who were moderately addicted to
nicotine, when the cigarette cue was presented next to the image
of the beloved (compared to the acquaintance), less activation
was observed in regions associated with cigarette cue-reactivity.
Additionally, more activation in the caudate was observed during
trials that included the beloved’s pictures (compared to the
acquaintance’s).
These preliminary data provide more evidence that romantic
love could be considered a powerful and primordial natural
addiction because it can, under some circumstances, modify
brain activations associated with a more contemporary addiction,
nicotine.
“Self-expansion” and “incorporation of others into one’s sense
of self” may also act as reward substitutes for addictions,
including love addiction.
First proposed by Aron and Aron (1986), the self-expansion
model proposes that a basic human motivation is the desire to
increase one’s self-concept by engaging in novel, interesting,
challenging and/or other exciting pursuits in order to gain
resources and perspectives that can enhance one’s self
concept and capabilities (for review see Aron et al., 2013),
as well as garner positive emotions and reward feelings
(Aron et al., 1995, 2000;Strong and Aron, 2006). They
propose that rapid self-expansion occurs during early stage
romance.
This self-expansion, which is rooted in approach motivation
(see Mattingly et al., 2012), may be beneficial when attempting to
quit or reduce use of a substance or behavioral addiction because
it offers a replacement and distracting rewarding experience. Self-
expansion in the context of romantic love has been shown to
attenuate perceptions of physical pain (Younger et al., 2010) via
a reward mechanism (rather than distraction), which suggests
that it might assist with the painful process of withdrawal
after romantic rejection. Further, self-expansion may also be
beneficial in the context of quitting any addiction because it
facilitates self-concept change (e.g., starting to think of oneself as
a writer, musician, bird watcher or whatever the self-expanding
experience may be) into a new and healthier direction, and
away from one’s identity as a “user” (Kellogg and Kreek,
2005). In addition to providing distraction, replacement and
redirection, engaging in self-expanding (i.e., novel, interesting,
and/or challenging) activities may be biologically beneficial,
because any form of novelty activates the dopamine system in
the brain to facilitate energy and optimism, thereby potentially
providing a replacement reward.
Indeed, three studies have directly investigating self-expansion
in the context of nicotine addiction, each finding quite
positive results. Ex-smokers reported that significantly more
self-expanding experiences had occurred directly before they
successfully quit smoking than did current smokers who reported
on their unsuccessful attempts to quit (Xu et al., 2010). Even
among the current smokers who relapsed, the number of
self-expanding experiences occurring directly before their quit
attempt was significantly positively correlated with how long
they were able to abstain from smoking (Xu et al., 2010).
Two fMRI studies of overnight abstinent smokers suggest that
self-expansion via activities with a romantic partner attenuates
cigarette cue-reactivity in the brain (Xu et al., 2012, 2014). These
data suggest that when smokers engage in self-expansion, they are
less responsive to smoking cues.
Another cognitive phenomenon that may play a role in
attenuating romantic addiction is “inclusion of the other in
the self” (IOS). This occurs when representations of the self
change to incorporate aspects of a romantic partner. A scale
has been developed to measure this cognitive process (Aron
et al., 1992). Over time the partner’s perspectives, identities, and
resources become incorporated into the person’s own sense of self
and the distinction between self and partner blur. For example,
people transition to more use of plural pronouns like “we” and
“us”(Agnew et al., 1998), and become slower at distinguishing a
partner’s belongings or traits from one’s own (Aron et al., 1991;
for a review, see Aron et al., 2004). This growth of the self-concept
can provide positive outcomes (e.g., additional resources, positive
feelings), which may be effective in a therapeutic situation.
Indeed, activation of the reward system through the VTA was
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Fisher et al. Romantic Love As an Addiction
correlated with a lover’s IOS scores (Acevedo et al., 2011),
which suggests that a moderate amount of positive identification
with another person or group could be therapeutic–by boosting
a positive self-image and providing a reward substitute for a
substance or behavioral addiction that a person has given up.
IMPLICATIONS FOR TREATMENT OF
ROMANTIC REJECTION AND
ADDICTION
Clinicians have a host of strategies for helping lovers and
drug addicts. However, when data on romantic love and
substance abuse are considered together, some approaches have
a particularly strong rationale.
Perhaps most important, like giving up a drug, rejected
lovers should remove all reasonable evidence of their abandoning
sweetheart, such as cards, letters, songs, photos, and memorabilia,
as well as avoid contact with their rejecting partner, because
reminders and partner contact can act as cues that induce craving
and are likely to sustain the activity of brain circuits associated
with romantic passion and thus interfere with the healing process.
Self-expansion research also finds that positive outcomes such
as personal growth and positive emotions are possible (even
likely) following a break-up if the relationship had offered few
self-expanding opportunities and if the newly single person
engages in rediscovery of the self (Lewandowski and Bizzoco,
2007).
Close, positive contact with a friend or friends is rewarding
and may also help to replace the craving for substances or
a rejecting partner, because looking at a photo of a close
friend activates the nucleus accumbens, associated with reward
(Acevedo et al., 2011). Looking at a photo of a close friend
also activates the periaqueductal gray, associated with oxytocin
receptors and the calm of attachment. This suggests that group
therapies, such as Alcoholics Anonymous and other 12 step
programs, are successful because these group dynamics engage
the brain’s reward and attachment systems. Participating in group
programs may be important for rejected lovers as well as for those
addicted to substances like alcohol or those with a behavioral
addiction, such as gambling.
Data suggest that rejected lovers should also stay busy to
distract themselves (Thayer, 1996;Rosenthal, 2002). Physical
exertion may be especially helpful as it elevates mood (Rosenthal,
2002), triggering dopamine activity in the nucleus accumbens
to bestow pleasure (Kolata, 2002). Exercise also increases levels
of β-Endorphin and endocannabinoids which reduces pain and
increases feelings of calm and well-being (Goldfarb and Jamurtas,
1997;Dietrich and McDaniel, 2004). Also, engaging in a new
form of exercise can be a self-expanding experience (see Xu et al.,
2010). Because of these benefits of exercise, some psychiatrists
believe that exercise (aerobic or anaerobic) can be as effective
in healing depression as psychotherapy or antidepressant drugs
(Rosenthal, 2002).
Self-expanding activities (e.g., hobbies, sports, spiritual
experiences) can be helpful both in the context of addiction
and heartbreak as they offer reward, benefits to the self-concept,
and distraction. It is recommended that a person has more
than one source of self-expansion in their life, thus should one
no longer become available (e.g., a partner leaves), the other
sources can help buffer the impact of that loss. It would also be
helpful to have multiple and diverse sources of self-expansion in
various domains of life (e.g., hobby, workplace, friends, family,
volunteer organization, spiritual group, and academic interest
etc.) and to have strong social networks to which one can
turn for support in times of need (e.g., breakup, attempting
to quit). It is important, however, to note that self-expansion
should be pursued in a healthy manner with caution about
potentially risky behaviors (e.g., seeking to fall in love with a
new person immediately after the loss of a partner, picking up
unhealthy habits or becoming an addict of another substance
when quitting).
Similarly, it is important to remember that relationships and
addictions can co-exist and influence each other and it may
be especially difficult to have a strong and positive romantic
relationship when issues of addiction need to be dealt with.
As addiction often leads to less desire for and response to
alternative rewards, it may be especially difficult for those
dealing with addiction to engage in pro-relationship behaviors,
and thus increase the risk of rejection. In addition, romantic
rejection increases the risk of relapse, so close attention to
romantic relationships during substance abuse withdrawal may
be important.
Furthermore, smiling utilizes facial muscles that activate nerve
pathways in the brain that can stimulate feelings of pleasure
(Carter, 1998). Focusing on the positive may be effective too.
A study by Lewandowski (2009) found that writing for 20 min on
three consecutive days about a recent relationship break-up was
beneficial when people wrote about positive feelings as opposed
to when they wrote about negative feelings or wrote without
expressing any feelings. Perhaps most important, time attenuates
the attachment system. In our study of rejected men and women,
the greater the number of days since rejection, the less the activity
in a brain region (the ventral pallidum) associated with feelings of
attachment (Fisher et al., 2010).
As disappointed lovers use strategies originally developed
to quit a substance addiction, their love addiction is likely to
eventually subside.
CONCLUSION
Researchers have long discussed whether the compulsive pursuit
of non-substance rewards, such as uncontrolled gambling,
eating, sex, exercise, Internet use, compulsive buying disorder
and other obsessive behavioral syndromes can be classified
as addictions (Frascella et al., 2010;Rosenberg and Feder,
2014). All can lead to salience, obsession, tolerance, emotional,
and physical dependence, withdrawals, relapse and other traits
common to substance abuse. Moreover, several of these non-
substance rewards have been shown to produce specific activity
in dopamine pathways of the reward system similar to drugs of
abuse (see Frascella et al., 2010; see Rosenberg and Feder, 2014).
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Fisher et al. Romantic Love As an Addiction
This suggests that uncontrolled use of these non-substances can
be considered addictions. Romantic love is likely to be a similar
addiction, with one exception. Unlike other addictions (that
afflict only a percentage of the population), some form of love
addiction is likely to occur to almost every human being that
lives now and in our human past; few avoid the pain of romantic
rejection either.
Romantic love appears to be a natural addiction, “a normal
altered state” experienced by almost all humans (Frascella
et al., 2010, p. 295) that evolved during human evolution
to motivate our ancestors to focus their mating energy on a
specific partner, thereby conserving mating time and energy,
initiating reproduction, triggering feelings of attachment and
subsequent mutual parenting, and assuring the future of their
mutual DNA (Fisher, 2004, 2011, 2016;Fisher et al., 2006).
Romantic love may be a positive addiction when the relationship
is reciprocated, non-toxic and appropriate; but a harmful,
negative addiction when unreciprocated, toxic, inappropriate
and/or formally rejected.
To alleviate the negative symptoms of love addiction, addicted
lovers are advised to remove the cues that fan their ardor,
follow some advisories of a 12-step program, build new daily
habits, meet new people, take up new interests, find the
appropriate medication and/or therapist, and wait out the days
and nights of intrusive thinking and craving, because feelings
of attachment to a former romantic partner decrease over
time (Fisher et al., 2010). Moreover, therapies that increase
self expansion and incorporate new individuals into one’s
sense of self may also be useful in alleviated love addiction.
Self expansion approaches may help drug and other negative
addiction therapies, also.
If the public and the therapeutic, medical and legal
communities come to understand that passionate early stage
romantic love is an evolved drive (Fisher, 2004) and a natural
addiction (Frascella et al., 2010) that can have profound
social, economic, psychological, and genetic consequences (both
beneficial and adverse), clinicians and researchers might develop
more effective procedures for dealing with this powerful and
primordial neural mechanism for mate preference and initial
partner attachment, romantic love.
AUTHOR CONTRIBUTIONS
HF wrote half the text based on her ideas and data from previous
studies and edited the final version. XX wrote twenty percent of
the text based on her ideas and data from previous studies. AA
contributed to the text based on his ideas and previous studies.
LB wrote thirty percent of the text based on her ideas and data
from previous studies and edited the final version.
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Conflict of Interest Statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
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