There are few topics as loaded as addiction – especially if you’re talking with someone (perhaps yourself) who’s struggling with an unhealthy attachment to a substance (such as alcohol, drugs, or food) or behavior (gambling, sex, or shoplifting). We generally don’t like to feel as if we’re in the grips of a behavior that we can’t control.
Not to minimize the potentially devastating effect of addiction, but it’s possible that at times this term is tossed about too loosely in our society. People talk about being “addicted” to chocolate or exercise, for instance, when they may merely be referring to a preference of theirs that harms nobody and is perhaps beneficial – but how to know when one crosses the line?
Any activity in excess, and which preoccupies us to the extent of endangering our health, relationships, or ability to work, could be an addiction. The issue is not always how much or how often we engage in the behavior, but how it’s affecting us.
Some questions to ask yourself:
1. Is this behavior compulsive? Do you find yourself obsessed with obtaining, using, or recovering from the substance or habit? Addictions often develop when a person perceives their life circumstances as overwhelming, and they become attached to a particular behavior (or thinking about the behavior) as a means to cope. Sometimes obsessing and acting on the compulsion become the person’s primary means of dealing with life. Whether the behavior takes the form of frequently checking one’s Facebook account, running on the treadmill for hours, or being consumed by work, is it front and center in your mind much of the time? Or do you have other ways to soothe, nurture, and reward yourself? What other things in your life do you find fulfilling?
2. Do I feel a loss of control around this behavior? Let’s say that you’ve established a boundary for yourself of two glasses of wine a night, and then you find yourself unable to limit yourself to this amount. Does this cause you distress? Or have your family members, friends, or work associates expressed concern about your drinking? For instance, you may think that you were the life of the party last night, but feedback from others may reveal that you caused other people to feel uncomfortable or offended, and that they were concerned about your well-being.
3. Do I continue to engage in this behavior despite negative consequences? Is your compulsion or loss of control leading to problems for you, your family, friends, or your finances, work, or health? Do you recognize that your preoccupation with checking your work e-mail at home is distancing you from your family, but you’re unable to stop? Have you received several DUIs, but you still drink alcohol? Are you still consuming a lot of ice cream or donuts despite your doctor informing you that you’ve developed type 2 diabetes?
4. What happens if I try to stop this behavior? Often the best way to determine the extent of your dependence on something is try to temporarily do without it. While most changes are likely to throw us a bit at first, a drastic reaction to abstaining from a substance or activity could give you some clues as to what role that item plays in your life. Do you become irritable? Depressed? Lonely? Bored? Anxious? On the plus side, once you gain some clarity on the situation, you’ll be a better position to seek help with the underlying issues.
Maybe your responses to the above questions sound an alarm, alerting you that you may need help. Or perhaps you honestly feel that your habits aren’t destructive and may in fact be augmenting your life. Ultimately you’re in charge of your decisions and their consequences.
As far as treatment for addiction goes, there are numerous options.
12-Step programs such as Alcoholics Anonymous view addiction as a spiritual as well as physical and emotional issue, and thus recovery is considered an in-depth, long-term, and possibly lifelong process. The 12-Step approach generally takes the view that a person is an addict for life, and that sustained recovery depends upon continual involvement with the program and identifying oneself as an alcoholic, addict, or whatever the compulsion may be.
While 12-Step programs have helped many people, the concept of having a lifelong addiction is not palatable for everyone. And, actually, it’s not always true. However, 12-Step programs are often worth a shot, provided that one maintains an open mind and actually does the work, rather than stewing in resentment about being forced into treatment and the various 12-Step principles. As is often said, “AA is for people who want it, not for people who need it”. Also, if you eventually find that your addiction has lifted, you can always leave the program and see how you do.
Cognitive-behavioral therapy (CBT), both in individual and group formats, is another good treatment option, having a strong track record in numerous clinical research studies. Based on the idea that your thoughts and beliefs cause your feelings and behaviors, CBT is an education in how to unlearn specific patterns and reactions, as well as an education in a new way of reacting.
Relapse prevention utilizes CBT principles to identify, anticipate, and prevent high-risk situations that might lead one back into addiction. CBT usually separates you from your behavior (i.e., you aren’t an addict, but a person with behaviors that may not be serving you well). However, CBT is not necessarily incompatible with 12-Step participation, and people can benefit from using both approaches simultaneously.
Motivational interviewing (MI) focuses on the client’s perception of their behavior, its effect on their life, the client’s motivation to change, and any ambivalence that may be present. In MI, the therapist doesn’t confront the client but instead “rolls with the resistance”, recognizing that we are more likely to make changes when we choose to do so, rather than when change is forced upon us.
Dialectical behavioral therapy (DBT) combines cognitive-behavioral techniques with mindfulness and acceptance principles, with the goals of helping you:
• tolerate discomfort without acting out destructively
• learn better emotion regulation (neither too extreme nor inhibited)
• interact with other people more effectively, and
• live more in the present moment (rather than ruminating about the past, worrying about the future, or trying to escape your current reality).
DBT has an impressive amount of research backing its effectiveness in treating substance abuse, eating disorders such as binge eating, anxiety, depression, and borderline personality disorder.
As for whether or not it’s necessary to completely quit certain habits, this varies from person to person. Certain substances (such as methamphetamine and heroin) are so powerfully addictive from a physiological standpoint that it would be very difficult to partake of them in moderation. When it comes to alcohol, obviously there are many people who drink and don’t become alcoholics, but one’s genetics and the relationship one develops with alcohol may make it preferable to abstain entirely.
As with an intimate relationship, once you’ve gotten to know someone, you can never again meet them for the first time – your mind (and body) will automatically react, based on past experience. Maybe you can forge new neural connections and healthier behavioral patterns – maybe not. Again, you be the judge, but proceed with caution.
It gets even trickier with behavioral addictions such as relationships, sex, shopping, or using the Internet. Very few people would advise complete abstinence from any of these behaviors, all of which are generally part of a healthy life. This is where compiling an enhanced set of techniques with which to deal with life comes in, so that you don’t lean too heavily on any one item.
However you assess your current situation and the hold that your habits may or may not have on you, try to remember that your main goal is to have a fulfilling life. Yes, it’s important to explore the possible reasons why you’ve become attached to a particular behavior – definitely. However, at a certain point it’s important to turn from asking “why” to asking “what now”.
Focusing on your strengths and passions is at least as important as recognizing and dealing with a potential obstacle in your path. It may help to recognize that when you remove a compulsion or obsession from your life, you make room for infinitely more satisfying pursuits.