Addictions

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Addiction is one of the most common problems I see in my practice and it comes in many forms … alcohol, drugs, sex, love, relationships, pornography, thrill-seeking, exercise, religion, food, anorexia/bulimia, video games and more. One thing I’ve learned over the years is that addiction treatment often takes priority over everything else, as not dealing with it means most of the therapy we will be doing will be pointless, as if treating a sniffle when a person really has pneumonia.

You will find that my attitude with addictions is tough, because that is what it takes to get an addict to do what they must do to get better. Addicts are world-class manipulators, deniers, and excuse-makers, because their sole objective is to keep the addiction alive, and that is why a therapist must take a tough stance with the illness. Sometimes I am the first person who has ever told the addicted person that the problem he or she has is serious and must be treated proactively. If you or a loved one has an addiction, rest assured that I am experienced in dealing with these types of issues. If in the assessment process I can see that a person will benefit from more extensive treatment such as Alcoholics Anonymous, Al Anon, Sex & Love Addicts Anonymous, in-house rehab, or whatever, I will be able to team with you to assist in making the right decision and helpful choices for you and your family.

Understanding Addiction

“Some people experience more pleasure, or glow, from alcohol than others. How much pleasure a person gets from alcohol may be partly determined by heredity.”[1]

When someone drinks, the pleasure they receive will be short-lived, and the feeling that follows will be discomfort. Therefore the substance of choice brings a person both the feeling of comfort and discomfort. The happy feeling is the high that the substance brings, and the unhappy feeling is called craving.  To an addict, nothing quiet quenches the unhappiness like the drug that produced it.  As the alcoholic progresses through the cycle of the disease, he or she will drink more to overcome the unpleasant effects rather than to achieve the pleasure that it brings.

It is important to understand that just because a person does not drink or use substances daily does not mean he or she is not an addict. Addictions can present in various forms such as weekend abuse, occasional benders, or other non-typical patterns of usage.

Common Personality Traits of the Addicted Person

  • Have mood swings
  • Be unreliable
  • Be unable to finish projects
  • Have unexpressed resentment
  • Be dishonest and lie to family, friends and employers
  • Isolate and withdraw from loved ones
  • Appear chronically depressed
  • Begin stealing from family and friends
  • Engage in risky sexual behavior
  • Exhibit strong, primitive defense mechanisms (denial, rationalization, minimization, projection, justification, blaming)
  • Have difficulty paying bills
  • Have difficulty with interpersonal relationships
  • Have difficulty with work relationships or is unable to hold a job
  • Engage in illegal or immoral activities to obtain drugs

The Cycle of Addiction

Addiction is a progressive disease that gets worse over time. In alcoholism, for example, the typical cycle is as follows, with the end result negatively affecting the person at work, in relationships, and with him/herself.

The Cycle of Addiction Is Characterized By:

  • Frustration and internal pain that leads to anxiety and a demand for relief of these symptoms
  • Fantasizing about using alcohol and drugs or behaviors to relieve the uncomfortable symptoms
  • Obsessing about using drugs and alcohol and how his or her life will be after the use of substances
  •  Engaging in the addictive activity, such as using substances to gain relief (acting out)
  • Losing control over the behavior
  • Developing feelings of remorse, guilt and shame, which lead to feelings of dissatisfaction
  • Making a promise or resolve to oneself to stop the behavior or substance use

After a period of time, the pain returns, and the addict begins to experience the fantasies of using substances again.[2]

Breaking the Cycle of Addiction

The stages of the cycle of addiction can be matched up with some of the stages of the model of behavior change and its relationship to recovery.

  1. Precontemplation -The addict has not yet considered stopping the behavior or use of substances.
  2. Contemplation – The addict is starting to consider making a change in behavior.
  3. Preparation – The addict is mentally and, possibly, physically preparing to make a change.
  4. Action – The addict has taken an action, such as seeking treatment, self-help groups or counseling. Treatment has been provided and the addict has stopped using.
  5. Maintenance – The addict is maintaining his or her new lifestyle and behavior, following a recovery program

Unfortunately, relapse can occur during the action or maintenance stage, which means the addict or alcoholic again enters the cycle of addiction.[3]

[1] Alcoholism, the facts. Goodwin, Donald. W. Oxford University Press. 2000.
[2] http://www.recoveryconnection.org/cycle-of-addiction/
[3]  http://www.recoveryconnection.org/cycle-of-addiction/