An addiction is the inability to consistently stop a behavior or the use of a substance. Over time tolerance builds, so more is needed for the desired effect. Stopping creates negative feelings and sometimes physical symptoms of withdrawal. Even though there is an awareness of the destructive effects of the addiction, it continues in a compulsive and persevering manner. There may be cycles of relapse and remission, but addiction typically leads to increasing disability and interference with a persons life.
While the definition is easier to see with substance use, it also applies to behaviors and habits. Even things that are healthy and needed, like work, exercise or the pursuit of a loving relationship, can develop into an addiction that robs the person of freedom, balance, and happiness in their life. For example, it would be difficult for a person to have proper self-care and connected relationships if they are spending hours a day at the gym or maintaining regular 60 hour work weeks.
Most addiction I see as an addiction therapist has both physiological and psychological components that addiction counseling must address. Probably the easiest part to see is the bodies physiological response to an addictive behavior or substance. Over time, the pleasure/reward brain circuit becomes stronger and even the body begins to respond differently in anticipation of acting on the addiction. As the old Nike slogan goes, “If it feels good, do it.” Over time, an addiction gives less and less of a pleasure response causing a need to increase the frequency/intensity of the addiction just to get the same pleasure response in the brain. It seems that genetics likely play a part in addiction given the patterns of addiction within families.
Psychological aspects can also drive addictive behavior. Someone with an anxiety disorder may come to depend on an increasing use of alcohol to dull the anxiety for a time. For others, it may be feelings of emptiness that they use food to fill or an insecurity where sex is used as evidence they are wanted.
An addiction therapist can help by first organizing and structure the help and support that will best help an individual and their particular need and struggle. This may be a mixture of “talk therapy” and possibly medication. With the chaos that often surrounds addiction, having an outside perspective to help guide the process can be a welcome relief.
Aristotle said, “Nature abhors a vacuum,” and the parts of a person that feel overwhelmed or empty are usually the “empty spaces” an addiction moves in to fill. An addiction therapist focuses in on these empty or vulnerable areas to help a person grow and develop into a more solid individual, free to make choices and balance their life. This may involve identifying or developing areas of self-care that prepare a person to handle life stress on their own with more resilience. It might involve working on areas that help a person connect better in relationships so that they are not as lonely. Or, addiction counseling may involve addressing other underlying psychological conditions, such as depression, that may drive an addiction. Wherever the empty spots are, an addiction therapist can help equip a person for a happy and balanced life free of addiction to substances or behaviors.
Medication can be useful for helping break free of addiction in some situations for two reasons. First, it can help with the psychological symptoms, such as depression or anxiety, that play a large part in patterns of addiction. Second, medication can help with the negative withdrawal symptoms that make it so difficult to stop an addiction. As always, make sure it is a psychiatrist working with you to help sort out what medication might be best for you. They are the experts when it comes to the medications of the mind.