Giving refuge, advancing research

Rajita Sinha, Ph.D., says that the emotional expressiveness of the Indian classical dance studies of her youth laid the foundation for a lifelong interest in the brain-body tango that regulates mood and behavior. As an undergraduate in her native Delhi, she studied biopsychology, conducting research on the effects of marijuana and working at a counseling center. For her graduate work at the University of Oklahoma Health Sciences Center, she studied how emotion is manifested physiologically, a thread that she has carried through her subsequent work on the brain-altering effects of drugs and alcohol.

Throughout, Sinha has observed and studied how people cope with stress and with wanting—“The abundance of choices available in the world, and easy access to commodities, including drugs, challenges the body’s motivational systems in novel ways,” she says.

Sinha, now Foundations Fund Professor of Psychiatry at the School of Medicine, is director of the Yale Stress Center (YSC), an interdisciplinary program dedicated both to treating the problems that can arise when people modulate emotions through drugs, alcohol, and eating, and to studying the brain mechanisms underlying stress, cravings, and addiction.

The YSC’s holistic approach is apparent upon setting foot in the door. The waiting room, which Sinha helped design, is decorated in calming muted colors, and a mini rock garden and soothing music contribute to an air of tranquility. The clinical side of the center, which opened last year, offers behavioral techniques, including biofeedback, nutrition, and yoga, to help people manage life stressors. One study in progress at the center is looking at the efficacy of mindfulness, a technique that Sinha says has helped her personally deal with stress.

After receiving her clinical psychology doctorate at Yale in 1992, Sinha joined the medical school faculty and developed models of how stress induces brain and body changes that stimulate addictive behaviors. New imaging methods helped Sinha, also professor of neurobiology and in the Yale Child Study Center, to characterize and validate the concept of stress-induced craving, an increase in motivation to seek out something mood-altering. “The conventional approach to addiction was, ‘People like to get high. If you take away the high, that stimulus won’t be reinforcing anymore, and they’ll stop using.’ It’s a behavioral model that didn’t work,” she says.

Missing from the equation, she says, was stress. In one of her experiments, stress increased subjects’ craving for alcohol, an effect that was more pronounced in binge drinkers. Drinking is relaxing in the short term, says Sinha, but over time it raises stress hormones, leading to a vicious cycle where more alcohol is needed to achieve the same relaxing effect. Changes in the brain that mediate these effects lead to cravings and addictive behaviors; similar changes are seen in food and gambling addictions, also being studied at the YSC.

Because her passion is science, Sinha says, “there’s always been tension between applying and seeing treatments work, versus understanding the mechanism.” It seems, though, that at the YSC the tension between clinic and lab is melting away: the center’s interventions for mind and body ultimately target the brain, and Sinha and colleagues can then study patients’ brains to come up with even more powerful treatments for stress and addiction.