The Nature of Addiction
Addiction is one of the toughest problems facing our culture today. The growing problems within the family, as well as many other cultural stressors, make addiction a national and international problem that has grown by leaps and bounds. In the U.S. we have promoted a "feel good right now" mentality that tends to feed the addictive process.
Contrary to some popular thought, people don't become addicted to drugs, alcohol, or sex just for the fun of it. There are usually reasons why an addiction happens. And these same reasons make an addiction difficult to stop.
Addiction has two elements that must be understood to grasp the true nature of it. The first element is tolerance.
A person is drawn to an addictive behavior or substance because of the way it affects his or her emotions. It enhances some feelings and numbs out others. Emotional pain is reduced momentarily...and the hope is that it will not come back. Of course, it does. Tolerance means that over time more and more of the behavior or substance is required to produce the desired effect. More intense sex or more alcohol is required to numb out feelings, or more cocaine is needed to get the heightened sense of excitement and competence.
Eventually the intensity of the behavior or substance needed to produce the high become dangerous in and of itself. Not only does one become an impaired driver in the case of chemical addictions, but an overdose can occur or the liver can eventually fail. In the case of sex one runs the risk of an arrest, loss of a primary relationship or job, or becoming infected with HIV. And in the case of other behavioral addictions such as eating, spending, or gambling more and more intense experiences are required for satisfaction. Eventually even those fail.
The second element that is important to understand is withdrawal . Withdrawal means that an individual has a very painful physical and/or emotional reaction when the substance or behavior is stopped. Withdrawal happens in two phases: acute withdrawal and post-acute withdrawal. Acute withdrawal occurs within hours and days of the cessation of use. Alcohol withdrawal can be accompanied by hallucinations and delirium tremens. After a person has become adjusted to a certain level of the drug/experience removal of it affects the emotional/biochemical balance that has been established. The person then has to readjust to living without the previous level of stimulation, etc. Post acute withdrawal can last two years or more. It also has emotional and physiological aspects that are very difficult to endure.
As you can see, addiction is an ever-growing downward spiral which has NO pleasant ending. This is not a happy picture.
Factors that influence addiction
Genetics: There is often a genetic "leaning" towards one type of addiction or another. This is not to say that genetics alone is sufficient to put an addiction in place, but that the nature of the addiction may be influenced by genetics. For instance, an alcoholic often has alcoholic parents or grandparents and may have an unusually strong "positive" response to alcohol.
Trauma: Trauma can also shape and foster addiction. Sex addicts often have a background of being sexually abused as children, whether overtly or covertly (see the page on abuse). Alcohol and drugs are often used by individuals who have a history of trauma and post-traumatic stress, such as Viet Nam vets.
Shame: Another important concept in addiction is shame. Shame is a very powerful feeling that one has when he feels he does not measure up. It often masquerades as other feelings, but is always found in major proportions in the lives of addicts--both as a cause and a result of addiction. Shame spirals upwards as an addiction progresses.
Anxious depression: One last major contributor to addiction, in my opinion, is an anxious depression. An anxious depression is the type of depression in which the next two hours seems like the rest of your life, and you must do something to change how you feel. It is an agitated feeling, very different from the more melancholy depression that causes a person to sit in bed all day unable to get up or get dressed.
Tough early experiences, genetic predisposition (at times), shame, an agitated/anxious depression, and the processes of tolerance and withdrawal can easily result in addiction. What is not easy is recovering.
Recovery from any addiction is hard. Both acute and post-acute withdrawal must be allowed to occur without resorting to the addiction, the emotional issues that helped to cause the addiction initially have to be addressed, and the damage in the person's life caused by the addiction must be gradually corrected as much as possible. It is a lot of hard, tedious work.
12-step programs have been shown to be very helpful for most addictions. When a 12-step meeting functions as it should it provides a place where the addicted person can go to obtain help and fellowship without being shamed for having the addiction. Though individuals and meetings can wander from the best practices, the original basis of Alcoholics Anonymous was to offer help without telling one another what they "should" do. The 12 steps are only 12 suggestions, according to AA literature, and people are free to recover any way they wish. The meetings provide an opportunity to gain strength and hope from the stories of others, and to find friends and a sponsor (helper/guide) who can help them through their recovery.
Like any other movement, the 12-step programs and the people who attend them have plenty of faults. (I have had clients told by sponsors that they should leave therapy because therapists don't ever understand alcoholics!) Any good thing can be taken to an extreme and become unhelpful. For a particularly good book on this topic, read The Spirituality of Imperfection listed on the book list. It is written by an AA historian and is one of the best books I have ever read on either the 12 step programs or on spirituality.
A good recovery program from addiction usually includes the following elements:
Getting started in recovery
If you are considering entering treatment for an addiction, start by attending several 12-step meetings. You will know when you have found several that are good for you. Ask around for a good therapist, and look for someone who specifically works with addiction. Interview more than one therapist if you need to do so. Choose one that you feel can help you. And, do it today. The rewards are great and will begin sooner than you think!