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Addictions Therapy

An addiction is a persistent need to consume a substance or commit an act. This is distinct from a compulsion, which is an overwhelming and irresistible impulse to act. Usually, a compulsive act is preceded by obsessive, intrusive thoughts that compel the person to act, whereas an addiction is more of a habit that is not necessarily accompanied by obsessive thinking. An individual experiencing either addiction can benefit from seeking therapy. 

Identifying Signs and Symptoms

Compulsive behaviors include chronic gambling, substance abuse, sexual addictions, unrestrained shopping and spending, hoarding, excessive exercising, Internet gaming, eating issues, and other behaviors. Any compulsive behavior can become an addiction when the act is no longer able to be controlled and impairs a person’s ability to function socially, academically, and professionally. The distinction between “addiction” and “compulsion” can sometimes become unclear, as a person might think frequently about the object of the addiction, and it may become near-compulsive to pursue the addictive behavior.

Determining whether a habitual behavior has become problematic begins with evaluating the benefits associated with the activity and the feelings and beliefs surrounding it. The distinction between a passionate hobby and a compulsive behavior may be difficult to discern. Addiction or compulsivity may be indicated when the behavior results in feelings of distress, guilt, or shame or when abstaining from the behavior provokes anxiety or proves to be impossible.

Symptoms that suggest a compulsive behavior has become problematic include:

  • Interpersonal and professional relationship problems
  • Concealment of the behavior
  • Denial of a problem
  • Inability to stop the behavior
  • Alternating feelings of anxiety, confusion, shame, or elation that revolve around the behavior
  • Withdrawal from or a lack of enjoyment in other activities
  • Desire only for the company of others who pursue the activity or, to an opposite extreme, the urge to conduct the activity only in isolation
  • Fear surrounding the potential repercussions associated with discontinuing the activity

Related Conditions and Causes 

Typically, addictions or compulsions develop as a result of an underlying psychological issue, such as depression. Engaging in an act of addictive behavior can temporarily relieve stress or anxiety for several minutes to several days. Compulsive behaviors often trigger the same neurological pathways that specific substances stimulate in the brain of someone with drug addiction, and this cycle of reward can make the activity that much more attractive and addictive.

Addiction's Impact on the Family

Addiction is an emotionally destructive illness, is a family disease or problem, and it can be easy to underestimate the sometimes covert, but painful, "ripple effects" of addictive behaviors that lead to hurt, anger, isolation, depression, and despair.

Family members of an individual experiencing an addiction can develop high levels of stress, especially when daily routines are interrupted by that individual's unusual, uncharacteristic, or potentially threatening behavior. Children living in a family affected by addiction may find it difficult to cope with the anxiety, stress, or emotional overwhelm that may result from the chaos and stress in homes affected by a family member's addiction or compulsions. Addiction that continues to go untreated may have a traumatizing effect on both children and adults, leading to developmental concerns, difficulty regulating emotions, and relationship difficulties among family members or partners.

Adults who grew up with a family member who experienced addiction may have a higher likelihood of experiencing depression, anxiety, relationship issues, or learned helplessness. They may also be more likely to develop an addiction themselves, have difficulties with self-regulation, engage in high-risk behavior, or reenact a dangerous or dysfunctional cycle from childhood with their own partners and children.

Parents who experience addiction may come to increasingly rely on their children, placing the child in a parental role, which often has an effect on development and can cause difficulties in relationships later in that child's life. Individuals experiencing an addiction may also isolate themselves from their families due to guilt, a fear of censure, or denial, among other reasons. This isolation can make family interactions and relationships difficult and may also forestall treatment of the problem.

Therapy for Addictions and Compulsions

Compulsive behaviors and addictions may provide a person with a sense of power, euphoria, confidence, validation, or other feelings that may otherwise be lacking in their lives. Psychotherapy is designed to help people identify uncomfortable feelings and sources of distress in order to change and grow. People who struggle with compulsivity and addiction are unlikely to conquer those behaviors unless they work to address the underlying causes of their addictive and/or compulsive behaviors, such as trauma, stress, past abuse, and others.

Working with a therapist is one of the most effective treatments for managing compulsive behaviors and addictions, and there are many types of therapy suited to addressing behaviors that a person may want to change. A person is likely to achieve the most benefit from consulting with a therapist who is qualified to address the particular area of addiction or compulsion experienced, as well as the underlying cause of the issue. For example, a person who uses drugs to dull the intensity of posttraumatic stress may benefit from treatment for PTSD as well as drug addiction, but resolving the PTSD may also help significantly with treatment for the addiction. Self-help, support groups, and 12-step programs may also facilitate recovery from addiction and compulsivity.