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Shrink Rap

Changing society’s stigma around addiction and the word ‘addict’

By: Merrill Powers, LCSW
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Often clients tell me that they have “an addictive personality.” Sorry, no such thing. While there is evidence that some people might have a genetic predisposition, whether you become addicted depends on how the events in your life specifically affect you, your exposure to substances or behaviors, and by repeated use.
What is an addiction, or any compulsive behavior? Whether it involves alcohol, cigarettes, drugs, overeating, self-starvation, or the compulsive use of porn, video games, gambling or risky sex, addiction is a serious brain disorder. It is not a moral failing. Because of the stigma around addiction, people who need help avoid it. Society needs to change the stigma around the word “addict.”
The steps to recovery require turning off the addiction triggers; learning healthy coping skills for negative feelings; and clearing past trauma so that one can live, love, and pursue goals in the now, instead of living in reaction to the past. Then the addictive behaviors are neither necessary nor desirable. Recovery is about creating a life worth staying abstinent for!
An addiction starts as a coping mechanism. Typically people experiment when they are young, often early in the teen years. Getting high with friends can provide the positive sensation of belonging and connection, beyond the effect of the substance or behavior. A woman addicted to gambling told her story, “My dad would always come in to kiss me goodnight in the casino hotel room, even if it was 4 a.m. It left me loving that ‘casino magic.’ I’ve looked for it since then, and I’ll bet I look for it the rest of my life … .” What gets people hooked is the temporary escape from what is lacking in their reality.
Patrick Carnes, a leader in the addiction treatment field, defines an addiction as “any behavior that becomes a priority, replacing other priorities despite negative consequences.” The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) lists 11 criteria for the diagnosis. The most significant are using larger amounts than intended (tolerance); inability to quit (loss of control); time spent acquiring, using, or recovering (obsession); cravings and urges; needing more for the same effect (tolerance); withdrawal symptoms. Continuing to use despite adverse consequences, such as trouble with relationships, poor health, and not managing work, home, and school, and replacing social and work activities with the obsessive behavior or use, are signs of an addiction out of control. It’s time to get help.
Addiction has many faces. It’s an attachment disorder, usually originating in childhood. That’s why many children of addicts become an addict or marry one, and it can lead to a preference for a relationship with a substance or behavior. It’s a dissociative disorder, allowing the person to numb out feelings and separate from his/her authentic self. It’s a thought disorder, manifesting as:
• Denial (I can stop whenever I want.)
• Rationalization (I only drink on weekends.)
• Justification (I take pills because I’m in pain.)
• Blame (If you didn’t nag me, I wouldn’t leave to gamble.)
Our drug of choice depends on what meets the need, depending on how we experienced adverse childhood experiences. (See my article on ACEs, “A Test You Don’t Want to ACE,” Auburn Journal, October 2016.) Addicts speak of having “a hole in my heart” – a void that can’t be filled. Until an addicted person is able to heal his/her attachment wounds and develop a capacity for healthy interpersonal relationships, he/she will forever remain vulnerable to addiction of one kind or another.
But how do you develop a healthy relationship when you can’t trust? When you were repeatedly shamed early in life? Going to a 12-step meeting will provide fellowship and support from others experiencing the same recovery challenges. It can be the first step in healing attachment wounds. Going to a well-trained therapist can provide a safe environment to learn positive skills to manage feelings. Specifically, EMDR therapy addiction protocols can repair early attachment memories, turn off addiction triggers (e.g., using because you’re lonely or angry, in the kitchen while making dinner, etc.), and break the link in your brain between the positive feeling and the compulsive behavior.
A client had a drunken father, full of rage. As a child, he was not allowed to express his feelings. At age 9, he found pornography. He says it was the first time he felt alive. That was the start of his addiction to porn. Multiple EMDR therapy sessions allowed him to change his distorted childhood beliefs, “I can’t feel,” “I can’t trust,” and “I don’t matter” to the more mature beliefs, “It’s OK to feel,” “I can use my judgment to know who to trust,” and “I do matter.”
As the negative feelings from his early memories reprocessed, the positive feelings from his adult relationships emerged. As his desire to engage in the behavior decreased, he began to spend more time with his family and he was more focused on his job. Healthy behaviors filled his emotional needs, and the addiction urges soon disappeared.
Merrill Powers is a licensed clinical social worker in private practice in downtown Auburn. She specializes in EMDR therapy, and she has had many years of experience in the addictions field. Reach her at merrill@powerstherapist.com or 530-852-5066.