An addiction is when someone takes a substance or engages in a behaviour which is initially enjoyable or serves a purpose but whose continued use becomes compulsive and interferes with the responsibilities of everyday life. It’s been said about alcoholism, for example, that there’s a problem when drinking costs more than the price on the bottle. Among other things, we can be addicted to alcohol, drugs, nicotine and tobacco, inhalants and medication. A list of the most common behavioural addictions would include gambling, the internet, sex, spending, working and video games.

What are the signs of addiction?

Although addictions take many forms, certain symptoms are frequently present.

Among them are:

  • An inability to stop the activity – with or without regret afterwards
  • Intense craving
  • Escalating use due to tolerance
  • Repeated relapses
  • Risk-taking
  • Increased secrecy including lying
  • Neglecting other activities, interests or obligations with resultant declining performance in other areas of life such as work
  • Impaired relationships
  • Changes in sleeping patterns resulting in chronic fatigue
  • Sudden changes in mood, irritability, aggression, depression, apathy, suicidal thoughts
  • Financial costs
  • An increasingly obsessive focus on indulging the activity
  • Continuing the behaviour despite the negative consequences

With some addictions there may also be:

  • Slurred words or rambling speech
  • Frequent illness
  • Bloodshot or glazed eyes, flushed skin, broken facial capillaries, trembling hands, bloody or black stools, chronic diarrhoea, vomiting blood
  • Temporary blackouts or memory problems
  • Changes in weight
  • Withdrawal symptoms such as sweating, shaking or being sick
  • A deterioration in personal appearance and hygiene.

How do I know if I have an addiction?

There’s a lot of information about the symptoms of addiction in the public domain, not least online. However, it’s always advisable in the first instance to talk to a professional. Your doctor should be able to assess your difficulties and, along with medical professionals generally, provide you with a non-judgemental context in which to talk things over. There are also specialist addiction helplines run by the NHS, charities or private organisations which are used to giving sensitive, confidential help to those making initial enquiries.

What are the causes of addiction?

One of the most common addictions for which people seek help is alcoholism. What follows applies to alcoholism but also to most addictions.

Growing up with parents who have an addiction makes it more likely that one may develop an addiction oneself. So does the early use of addictive substances and activities or living and working in an environment where such substances or activities are used by other people.

Addictions tend to be more common in those with mental health problems such as depression or anxiety. Stress can also be a factor as can emotional damage, abuse, deprivation, confusion or trauma in childhood. Other influences like abandonment, family discord, anti-social or aggressive behaviour in a parent, mental illness in a parent and over-controlling parents may also play a part. A very good book exploring the mechanisms of addiction – and on which I’m drawing here – is The Psychodynamics of Addiction, edited by Martin Weegman and Robert Cohen.

Trying to contain pain

We all know that addictions can be physical but there’s often a psychological addiction too. A relationship with a ‘drug’ takes the place of a relationship with a person. When I say ‘drug’ I mean any kind of addictive substance or behaviour. Sometimes something has gone wrong with a relationship with a parent or other caregiver in childhood with that person not providing containment for the child’s otherwise uncontainable emotions. In the present, the ‘drug’ is used to contain and process painful feelings originating in the past. This may be beyond conscious awareness. The trouble is that more and more of the ‘drug’ is needed to contain the pain because a tolerance is built up and simultaneously the ‘drug’ increasingly diminishes one’s own ability to contain the pain from inside or from painful external situations. A vicious spiral downwards is established.

Trying to find security

A child’s normal instinct is to be close to their mother for security and reassurance if they perceive danger to themselves or a threatening separation from her. In an addiction, a person may use a substance or a behaviour in a similar way. Stressful situations generating negative emotions (which so often precede an addictive episode) drive them into the ‘secure’, ‘satisfying’ and ‘comforting’ embrace of the object of their addiction. They may feel this preferable to relatively precarious attempts to relate to human beings and may have the illusion that they don’t need people.

Trying to counter low self-esteem

If all goes well, a child’s parents will reinforce his or her sense of strength, solidity and self-esteem while the child in turn admires and feels part of the parents’ calm and apparent infallibility. Over time, the child takes into themselves the capacity to perform the self-accepting, self-comforting and self-motivating functions implied by this. The child learns to regulate their own wellbeing. When this process goes awry, a person may use a ‘drug’ to make up for something missing in the building blocks of the self.

The problem is that, although the ‘drug’ may make someone feel better (for instance, more accepted, powerful or stimulated) in the short term, no real strengthening or permanent learning from life are happening. In fact, confidence is being undermined because each time the ‘drug’ is used, the person receives fresh confirmation that they’re not able to solve their central predicament, leaving them in a worse state than before. Self-esteem is lower and so they start all over again.

Addiction counselling. What can be done about addiction?

Addiction probably needs addressing on two levels. An essential first step is to stop the acting out of the addiction and to keep it stopped. The fastest and most effective way to do that is with CBT (Cognitive Behavioural Therapy), sometimes combined with medication. CBT teaches a person simple skills to interrupt the cycle of addiction with new ways of thinking, feeling and acting.

Once the symptoms of the addiction are under control, there may be a wish to work on its underlying causes. That’s where analytic psychotherapy can come in. Unlike CBT which may work relatively quickly, it’s going to the roots of the addiction and tackling them and that will take a fair amount of time. If you think how long it takes for problems to be generated in a person, it’ll be clear that a magic wand can’t be waved to unearth and work through those areas. As with any therapy, there can be no assurance of success but the goal of analytic psychotherapy is long-lasting change.

It’s important to know that I would need to be sure that anyone interested in therapy had not been acting out their habit for a year or so.