The Psychology of All Addictions

By Steven T. Griggs, Ph.D.

I have been a practicing psychologist in an outpatient setting for over thirty-two years. I run into the same issues and problems almost every day--addictions, anxiety, assertiveness, anger problems, divorce, weight management, parenting, children and teenager's behaviors, mood disorders, relationships, self-esteem, guilt, forgiveness, procrastination and ADHD/learning disabilities. This ebook is about the first subject. In it, I take you through the steps I go through to diagnose and treat addictions--ANY addiction.

I start out with a NEW concept--the Universal Self-Test for Addictions (USTA). It's a self-test you can score for yourself or someone you suspect has an addiction. It comes with complete instructions for scoring and interpretation.

In this ebook, I answer a LOT of questions. Here they are:

What are the short and long definitions of addiction?
What are the four major diagnostic components?
What are the four additional concepts that define it?
What are the symptoms?
What four psychiatric illnesses mimic addiction?
What are the six major addictions? (Hint: Alcohol, Drugs, Gambling, Sex, Food, and Internet or Internet-related things)
What are some other addictions? (I came up with 73...)

What are the seven categories and five schedules of drugs?

What are the current statistics for each addiction?
How are all addictions the same or different?
What are the myths and facts?

What are the seven stages of developing an addiction?
(Another NEW concept: The Addiction Developmental Continuum)
What are the causes of addiction?

Habit or disease?

Triggers? What happens next?
(Another NEW concept: The Addiction Reflex)

What happens to the brain?

What are the seven stages of treatment?
Which is better? 12-Step Programs? Smart Recovery? Individual Therapy?
Questions to get started--46 things to ask in treatment.
What are the five most helpful therapeutic aids?

The deep stuff: Family-of-origin relationships, relationships with others, Self-Esteem.
Cognitive Behavioral considerations: the relationship of thoughts and the emotions that follow, your moods and last, the relationship between your thoughts, emotions, mood and behavior.

What if you live with an addict? What to do?

Lastly, there is a section on quotes, followed by a lengthy bibliography.

• Language: English
• Publisher: Steven T. Griggs, Ph.D.
• Release date: Jul 30, 2016
• ISBN: 9781370519101

Steven T. Griggs, Ph.D.

I'm a psychologist. I write no-fat, how-to ebooks on subjects and conditions I fix everyday in the office. These include relationships, being assertive, struggling with guilt and/or procrastination, children and teenager's behavior, anxiety disorders, anger management, kids and divorce, self-esteem, child visitation, weight control, forgiveness, ADHD, addictions, and my latest, mood disorders. I've written 15 ebooks, and most of them are translated into Spanish. Now, I'm starting to write a book, "The Other Side of the Couch." It's about my daily experiences as an outpatient psychologist and how I see the world through the lense of a shrink...

Book preview

THE PSYCHOLOGY OF ALL ADDICTIONS

(And Pathways to Treatment)

by

Steven T. Griggs, Ph.D.

A PSYCHOLOGICAL CORPORATION

Copyright © 2016 Steven T. Griggs, Ph.D.

All rights reserved.

Distributed by Smashwords

August 2016

All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission, except in the case of brief quotations embodied in critical articles or reviews. Please do not participate in or encourage the piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions.

TABLE OF CONTENTS

INTRODUCTION

DEFINITION

Short

Long

Mood

Compulsivity

Damage

Lack of Control

Tolerance

Dependence

Bingeing

Craving

WHAT ADDICTION IS NOT

OCD

ODD

ADHD

Personality Disorders

ALCOHOL

DRUGS

GAMBLING

SEX

FOOD

INTERNET/VIDEO GAMES/ELECTRONICS

THE ADDICTION DEVELOPMENTAL CONTINUUM (ADC)

THE CAUSES OF ADDICTION

Habit or Disease?

THE ADDICTION REFLEX (AR)

ADDICTION PHYSIOLOGY

TREATMENT

THE NUTS AND BOLTS OF TREATMENT

APPENDIX A (Answer Sheet for Self-Test)

APPENDIX B

The Universal Self-Test for Addictions (USTA)

APPENDIX C (Other Addictions)

APPENDIX D (Living with an addict)

QUOTES

REFERENCES

OTHER EBOOKS BY THE AUTHOR

ABOUT THE AUTHOR

INTRODUCTION

As an outpatient psychologist, I see all types of problems and encounter people of all genders, races, ages, socioeconomic strata and sexual orientations. If there is one constant, it is addictions, which are very common. They occur everywhere and cut across all strata.

Statistically, one in four people in my office has suffered or is suffering from some form of addiction. In the USA, the modal addiction is still alcohol, but addiction to drugs, particularly marijuana is catching up. This isn't to say that drug addiction is not prevalent. It is seen more in medical clinics or other residential settings because it often has a more pronounced physical component and therefore needs medical or psychiatric supervision to treat. The more long-term an addiction, the more it requires a higher levels of intervention. Lest you think alcohol and drugs are the only addiction games in town, think again. Internet addiction is also catching up, as are all internet-facilitated addictions—the top four being sex, gambling, video gaming and even compulsively lingering on social media sites. Specifically, I'm seeing more video gaming problems in the younger crowd, gambling in the younger and middle-aged crowd and sex problems or downright sex addictions in all ages. All ages now applies to compulsive participation in social media, which now reaches down to age eight.

"No one is immune from addiction; it afflicts people of all ages, races, classes, and professions."— Patrick J. Kennedy

First, I'll define addiction and its many facets. Then, I'll present the addictions, one by one, giving statistics, characteristics and demographics. Treatment follows, but first there will be a discussion of how addictions develop and the phenomena of triggering. Last, there will be a discussion of what approaches are needed to master addictions.

DEFINITION

Here's the short definition:

Addiction is characterized by the inability to consistently abstain from certain activities, i.e., impairment in behavioral control. The hallmarks are craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response because of those activities. Like other chronic conditions, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

Here's the long definition:

An addictive behavior is any behavior that meets the following four criteria. It has to alter one’s mood. It has to be compulsive. It has to be damaging to some aspect of one’s life. And last, the person who is addicted cannot stop, despite the toll the behavior is taking. These criteria apply to ALL addictions. Let’s take these one at a time.

1) Mood. Mood altering refers to making oneself feel better. This means lowering anxiety, but the second most common use of an addictive behavior is to lift one’s mood out of some version of depression, guilt or other negative affect. An atypical version of altering dysphoria is when one has too much of an up mood, then addictive behaviors bring one down; for example, to help a person feel less manic. In the real world, people alter their thoughts and moods all the time by upregulating or downregulating their affective state, depending upon their tolerances. Every time we drink a cup of coffee or smoke a cigarette, we are altering our internal environment. But what makes this addictive behavior is when it alters our subjective state and then becomes compulsive.

2) Compulsivity. This is the state of being unaware of what we’re doing to alter our mood, but we do it anyway, habitually and usually relatively quickly. We have an urge to use a substance or indulge in a repetitive behavior, but because the origin of the urge is below the threshold of awareness, we experience it as automatic. There is little or no conscious control over the process. Usually this habitual dynamic creates consequences. Because it’s habitual and negative, there will be negative consequences. (If the consequences were benign we would not be discussing this in the same vein, although there are positive addictions that will be considered later.) View compulsivity as driving maladaptive behavior(s); that is, mending or altering a feeling or mood without much awareness.

3) Damage. Compulsive behaviors are automatic, unconscious habits that are indulged in too much. It’s one thing to drink a glass of wine or beer at a party. Few in our culture would strenuously object to such normal indulging at this kind of event. But what if someone drinks too much and makes a scene? What if they stumble and break something or hurt themselves? What if this is habitual? The drunk behavior might have spoiled the atmosphere of the party. Normally, this kind of behavior would be discouraged and the imbiber, if still in control, would cease. The out-of-control person will be ill-thought of, and probably would not be invited back. And, what happens when a drinker can’t stop?

4) Lack of Control/Can't Stop. The last of the four criteria occurs when an addict can’t or won’t stop (drinking, using drugs, being compulsively sexual, habitually eating too much, gambling too much, etc.) despite the fact that the situation or circumstance is negatively and usually significantly impacted. Marriages begin to fall apart, or, in the case of a food addiction, one’s weight climbs to dangerous, health-threatening levels; yet, the person continues to indulge in the addictive behaviors. Despite warnings from spouses, bosses and friends, the compulsive damaging behavior continues. Sooner or later the tensions reach critical mass, and bad things, sometimes very bad things happen. This is referred to as hitting bottom, but even then sometimes people don’t stop.

Additional Addiction Concepts:

There are three other concepts (and sometimes a fourth) that are commonly associated to addiction. I use these to assess the range of damage, duration and intensity of the potential addiction. These are tolerance, dependence and binging vs. chronic addiction patterns. The last concept is craving.

1) Tolerance. This refers to needing more and more of a substance or compulsive activity to get the same relief from dysphoria, or generally speaking, to achieve the high or at least escape the low. If, in the beginning of your drinking career, only one drink gave you a buzz, but later, after drinking for months, it takes two drinks, you have developed tolerance. The same is true of drugs, video games, pornography/sex, gambling and food.

Tolerance also means being able to tolerate increasing amounts of a substance; meaning, in this case, drinking more and more while maintaining functioning. This is usually a physical response to a substance, and marks the very beginnings of an addiction, even if one functions well despite increased consumption.

2) Dependence. This is when you need your addiction to perform. Without it, you do things poorly or not at all. For example: we’ve all heard of liquid courage. This is when we drink to find the courage to behave differently compared to how we might behave without alcohol. If your temperament is shy, you might use alcohol to loosen up enough to dance at a party, or speak to someone you find attractive. While this is common, the key is that you have developed a crutch, a dependence upon the substance or activity to successfully function. There is dependence when this becomes habit, or conversely, if you cannot comfortably function without your addiction of choice.

3) Bingeing vs. Chronic Use. Bingeing is the acute, more intense indulgence in an addictive behavior that usually results in more immediate, crisis-like consequences. Longer-term consequences will often be present but for now the focus is on indulging in addictive behaviors on a shorter-term, more intense basis that is punctuated by periods of abstinence.

Bingeing can occur with any addictive behavior. For example, you don't gamble for a while, and then over both weekend days you continuously gamble, and again abstain. This makes you look like an episodic heavy gambler but not a gamblaholic because you don't gamble during the weekdays. This error of thinking ignores the fact that when you do gamble or use drugs or overeat, you do it to excess, usually causing damage, only in a shorter period of time.

Bingeing contrasts to the more regular, everyday gambler or video gamer or compulsive eater who can't stop but who may or may not overindulge in gambling or drugs or alcohol or food in a less dramatic way. The emphasis here is on chronic; meaning, longer-term, more on-going patterns of use.

Note: Either bingeing or chronic use patterns can lead to the development of physical or psychological dependence, but the chronic pattern is more likely to create tolerance.

There is a fourth concept that is often paired with addiction. I isolate this because it is related to the above concepts so it doesn’t as easily or clearly function as a stand-alone experience.

4) Craving. This is an increasingly uncontrollable urge to indulge. Craving differs from compulsivity in awareness of the urge. Compulsivity may reflect craving but usually has less awareness associated to it, and compulsivity is more about automatic behaviors. Craving is usually more conscious. Craving is about feeling too strongly, wanting to use a substance or engage in a potentially addictive behavior too much.

Craving also lurks within dependence. It may be the driving force, motivating someone to use a substance or indulge in an addictive behavior in order to master an event or behave differently or to avoid feeling anxious or depressed if dependency needs go unmet. Again, it is not necessarily the sine qua non of dependence, but likely is a component.

Lastly, craving is usually behind mood-altering behaviors; in this case, lowering anxiety, which is a reward for avoiding pain. Likewise, improving mood also feels good.

In almost all cases, craving occupies a central place on the list of withdrawal symptoms, and is considered a classic sign of addiction. It tends to be progressive and the likelihood of