Addictions & Compulsions

Overview of Addictions & Compulsions: Compulsive behavior is not limited to substance abuse. Chronic gambling, sexual addictions, internet addiction, and a myriad of other, less widely known habitual behaviors are more common than one might suspect.

 

A compulsion is any behavior a person wishes not to carry out, but is unable to stop due to feelings of great anxiety and distress, which arise when the person abstains from the compulsive behavior. Usually, the word “compulsion” indicates the presence of obsessive thoughts, which lead to the compulsive behavior, whereas an addiction is more of a habit, not necessarily accompanied by obsessive thinking. Still, given how often an addict thinks about whatever he or she is addicted to, the line between “addiction” and “compulsion” may be somewhat unclear, even arbitrary.

 

 

Some relatively common addictions include:

 

• internet

• gambling

• food (especially sweets)

• coffee

• nicotine

• television

• new romantic/intimate relationships

• exercise

• sex

• masturbation

• pornography

 

The boundary between a passionate hobby and a compulsion or addiction may not be clear. Is running ten miles every day, rain, shine, or snowstorm, an addiction, or is it good athletic discipline? Is a monthly trip to Vegas a gambling problem, or just a fun escape from the daily grind? What about binging on ice cream, even when you know you shouldn’t?

 

A professional can help one determine whether behavior is compulsive. Possible questions and indicators might be

 

• Can you stop?

• What happens if you abstain from this behavior for a day, a week, a month?

• What are the benefits of this habit?

• What are the problems, if any, that it causes?

• Do you do this behavior with others, alone, or both?

• What else do you like to do?

• How do you feel about this habit?

• What are the thoughts and beliefs that are associated with this behavior?

 

If stopping is very distressing, or impossible; if the problems outweigh the benefits; if you have few other pleasures in life or have stopped participating in social activities; if you only do this alone, or always with the same people, who seem to be harmed by their participation; if you feel anxiety, confusion, shame, or alternating ecstasy and pain around this behavior; if you feel you must continue this behavior, or that you must stop, else some terrible feeling or experience will occur – this may be not a hobby, but an addiction.

 

The Medical Model and Addictions & Compulsions: As with addictions, causes, treatments, and theoretical models vary widely and are the subject of some controversy. Is addiction a disease, a choice, an unconscious result of childhood experiences, a biological tendency, an obsolete coping skill, or something else? Certainly, therapy has made progress in that we no longer view addiction as a moral failing. A bio-psycho-social-model, which looks at many different causes and treatments, is the preferred approach today.

 

Case Examples of Therapy for Addictions & Compulsions:

 

Morgan, 22, is a college student. He spends several hours on the internet each night, sometimes staying awake until sunrise and having trouble functioning in class the next day. He has friends at school, but finds himself isolating from them and becoming absorbed in the virtual world of the web. He does not look at porn, but plays games, chats, and does little else with his free time. His social life and grades suffer, but he cannot seem to stop. He reports feeling like he is in a daze, and says he is bored and anxious when he is not on the computer. Therapy reveals ambivalence about his major and the ensuing career it implies, as well as homesickness, social anxiety, and perhaps some chemical issues that tend toward depression. At the suggestion of his therapist, Morgan begins to involve friends in computer activities, watching movies with them and playing games in a group. This leads to extended social activities, and Morgan’s confidence improves. Career counseling steers him towards a more fulfilling path, and a few family sessions with his mother and brother uncover old grief that, once resolved, allows a better mood to prevail and socializing becomes enjoyable as it once was.

 

Daisy, 30, is disturbed by her own promiscuity, which has resulted in an unwanted pregnancy ended by abortion, as well as the contraction of sexually transmitted diseases, which were treated and remitted. Daisy is ashamed of her behavior but continues to meet new partners several times a week and engage in what she calls “totally meaningless sex”. Daisy does not know why she is driven to this behavior. In therapy, feelings of inadequacy, rooted in the experience of being criticized by, abused by, and eventually estranged from her parents, are discovered. Daisy realizes she is unsure of her own worth, and after several months discovers healthier ways of proving herself to herself, such as rock climbing and excelling at her job. Eventually, she begins dating and after experiencing true intimacy is able to abstain from compulsive sexual encounters.

 

Therapy for Addictions & Compulsions: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of addictions and compulsions. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for addictions other or any other issue, it is helpful to familiarize oneself with these elements.

 

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Addictions & Compulsions Article Summaries

Reversing Eating Disorder Relapse

By Joanna Poppink, LMFT I'm in the middle of attending a great conference at UCLA this week end. It's "Adult Attachment in Clinical Context: Applications of the Adult Attachment Interview." Superb and gifted researchers and clinicians are gathered to discuss and share information on the latest neuroscience findings, the reasons why humans bond or do not bond well with each other, how human relationships can harm and heal, and the powerful healing force of human love, compassion, stability, flexibility and reliability. As I participate in this conference, surrounded by clinicians ... Read the rest of this entry »

Study Finds Confidence in Restraint May Indicate Risk of Succumbing

A GoodTherapy.org News Headline Temptations, in myriad different forms, are available everywhere, often in copious amounts. To some people, temptation may take the form of a cigarette or stiff drink, while to others, a sweet snack or attractive person may represent the ultimate temptation. Most people are likely to report that they have a fairly high ability to resist temptation, but as a study recently performed at the Kellogg School suggests, those with strong convictions about such an ability are ... Read the rest of this entry »

Sex, Drugs and Body Image: A Coping Plan for Teens & Parents

As a therapist who offers counseling for teens and their families, I’ve become aware of some of the biggest issues facing young people today. While depression and anxiety remain two of the major reasons why parents seek my help, often these are not the first issues that drive them to consult a therapist about their child. Usually, it’s one of the “Big 3” teen issues of our day – Sex, Drugs and Body Image issues (which includes eating disorders and steroid use). Understanding the Adolescent Brain Adolescence seems to be ... Read the rest of this entry »

A Reflection of Addiction

By Patti Desert, LCSW When the news broke about New York Governor Eliot Spitzer's alleged involvement with a prostitute the nation was inundated with newspaper reports expressing shock and confusion. Politicians, corporate executives, and various other pundits were outraged by Spitzer's behavior? And healthcare providers began scratching their heads at the apparent level of ignorance about addictive behavior that these responses demonstrated. In fact, Spitzer's behavior is a classic reflection of a particular kind of addiction known as sex addiction. In the addictions recovery field providers refer to the "... Read the rest of this entry »

A Wolf in Sheep's Clothing: The Trauma Underlying Addiction

Written by Sarah Jenkins, MC, LPC Sit down, and let me tell you a story, a fable that tells of a wolf in sheep’s clothing. It is a fable, written by Aesop, that you may be curious to learn, and can tell us of addiction’s common deceptions. Perhaps you will find the lesson in the beginning, or even at the end, but you will be curious about what you will soon learn, as you read on. “A wolf found great difficulty in getting at the sheep owing to ... Read the rest of this entry »

Is Problematic Sexual Behavior Really Addiction?

by Rhoda J. Lipscomb, MSC, DAACS Recently it has become more commonplace to have clients come into my office and state that they have a sex addiction. Often when asked how this was diagnosed they respond that their spouse or other family member told them or they read a book and self-diagnosed. Sometimes when examined more closely, the client does not have a sexual problem at all, just a higher than average sex drive well as living in a sex negative environment. Many sexologists are beginning to speak out about ... Read the rest of this entry »

Adolescent’s Newest Addiction: Celebrity Worship

By Sherry Gaba, LCSW A frantic mother of a 15 year old daughter of a local suburban neighborhood tells her therapist that her daughter has quit the cheerleading squad, no longer dreams of college and becoming a lawyer, and her childhood friends have been replaced with friends she has never met. Her daughter has been isolating, reading all the latest celebrity gossip magazines, and becoming more rebellious at home. Clearly her daughter is pulling away which can be one of the hallmarks of addiction, depression, or an adolescent trying to form ... Read the rest of this entry »

Successful Weight Loss May Change the Brain

A GoodTherapy.org News Headline As a growing number of people tackled the challenges of losing weight and developing healthier lifestyles, those in the mental health professions and diverse medical fields are paying rapt attention to the ways in which people are able to generate self-control and find inner motivation. Recently, a study at Brown Medical School examined the link between successful weight loss and brain activity, scanning participants who were shown high and low calorie foods ... Read the rest of this entry »

America's First Internet Addiction Center Opens

A GoodTherapy.org News Headline Internet addiction may seem like a slippery slope to many who use the internet for working and engaging in social interactions, but some people may experience a strong tendency to crave internet and computer use to a debilitating degree. To address this issue, an internet addiction clinic has been opened recently in Washington state, with hopes of helping addicts return to a prosperous and balanced life. The program runs for the course of forty ... Read the rest of this entry »

Adult Video Game Players May be Less Healthy Physically, Mentally

A GoodTherapy.org News Headline Issues with rising obesity rates in combination with a growing percentage of people who report feelings of depression and anxiety have been considerable causes for concern in recent years, and analyzing popular trends and shifts in lifestyles may hold the key to understanding how and why the prevalence of basic physical and mental health concerns are changing. Seeking to examine the links between different media usage types and typical physical and mental health issues, the Centers for Disease Control along with two university teams have <... Read the rest of this entry »

Electro-Convulsive Shock Therapy for Internet Addiction Halted in China

A GoodTherapy.org News Headline A while back, we reported on a clinic in China that was attempting to treat young people whose parents believed they were suffering from “internet addiction,” defined as spending six or more hours per day online, accessing games or pornography rather than studying material, and becoming upset if access was cut off. The clinic was engaged in administering electro-convulsive shock therapy to its clients, a treatment that had many commentators concerned over the therapy's severity and doubtful efficacy. As Read the rest of this entry »

Living with Addiction

Written by Eric Denner, LMFT It can be very difficult to tell if someone has a problem with drugs or alcohol. In the past addiction was defined primarily by physiological measures: tolerance and withdrawal. In the past few decades the definition has expanded to include: - taking the substance in larger amounts or over a longer period than intended - desire or unsuccessful efforts to cut down or control use - a great deal of time spent in activities necessary to obtain, use, or recover from the effects of a ... Read the rest of this entry »

The Psychology of Addictions

Written by Marcia Singer, MSW, CHt. "All addictions begin and end with spiritual bankruptcy.” Dr. Kip Flock Years ago, in a bold attempt to release some of my own inner turmoil, I set out to gain a better grasp on the issue of addictions. John Bradshaw’s now legendary work with addiction, family systems and the shamed “inner child” had moved me deeply and sent me scurrying to the first series of codependency workshops for therapists developed by Bradshaw and colleague, Kip Flock, Ph.D. Codependency was the word coined ... Read the rest of this entry »

Silver Achievement Award for Smoking Cessation Program with Mental Health Focus

A GoodTherapy.org News Headline Efforts to advocate smoking cessation nation-wide and around the world have been accelerating in recent years as the understanding of the negative aspects of smoking improves. One program, called CHOICES, has won a Silver Achievement Award for its work with smoking cessation among those with mental health difficulties. As a significant number of smokers are faced with mental health issues, the program, which provides community support and logistics for people hoping to quite smoking, has delivered ... Read the rest of this entry »

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