Take the “SHH” out of addiction

Updated: Aug 17

A look at the reasons why being secretive and shameful is unnecessary.

I find it interesting to look at the definitions published for addict and addiction. One will state a “compulsive need to use a habit-forming substance” to the point of tolerance and physiological signs of withdrawal and constitutes this as a “state of being addicted” (Merriam Webster). Within this description about compulsion the examples they provide are nicotine, alcohol, or heroin. When referring to the word addict however it is simply explained as a surrendering to something in a habitual or obsessive fashion. In another, the explanation shifts somewhat to allow for a broader view, by referring to addiction as an enslavement to a habit or practice, something “psychologically and or physically habit-forming” ( that when removed prompts distress. Others bring in the possibility that being addicted can pertain to a substance, a thing, or even an activity.

You’re probably thinking, great, thanks for the vocabulary lesson, but I promise I am going somewhere with this. But first, I think it is important to look at the definitions that drive societies take on the meaning of the word addiction. The American Psychiatric Association has published their definition as “a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences”. They state that individuals with these “severe substance use disorders” allow drugs and alcohol to take over their lives. They talk about motivating factors such feeling pleasure, relieving stress, performing better, and social pressures with symptomology of impaired control, social problems, risky use or situations, tolerance and withdrawal. And then there is The American Society of Addiction Medicine where the short definition characterizes addiction as an “inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems… and dysfunctional emotional responses” due to a “chronic disease of the brain reward, motivation, memory and related circuitry”.

I’d say with descriptive words like compulsive, enslavement, inability, severe, and disease it makes perfect sense why people have such a dark opinion of addiction, fear of seeking help, or avoid being open about their struggles. The big “shh” makes some sense here, right? Then you look at the weight being placed primarily on being due to a “chemical” substance. This negates or at the very least softens any focus that may be needing to be made on other addictive situations and those things or activities mentioned earlier. And, it certainly sways you away from considering things that are so common they seem innocent.

So, what am I getting at?

For starters, yes, there are levels of severity that must be considered. And yes, high severity chemical dependencies such as an opiate use disorder that have reached the level of a physiological need for maintenance are different than say a sugar addiction that has also reached those levels. But what is important to understand is that the withdrawals from opiate use as well as, let’s say, sugar, are both filled with physical pain and discomfort. That’s right, withdrawal from sugar can look like anxiety, depression, cravings, muscle pain, chills, dizziness, nausea, vomiting, gas, headaches, irritability, extreme fatigue, disturbed sleep, and cognitive issues. Opioid withdrawal looks like anxiety, abdominal pain, nausea, vomiting, diarrhea, insomnia, tremors, restlessness, sweating, and goose bumps. Now don’t get me wrong here, yes, there is a big difference because overdosing is a very real and deeply concerning issue with opiate use. And I get it, overdoing it with the sugar doesn’t seem as devastating, I mean really, it could take years for sugar to be life threatening. Sugar diabetes is very real and takes many lives though doesn’t it? Honestly, as a practitioner, both types of addicts would engage in the same treatment, and I’ll tell you, when at the same place of readiness, the sugar addict is much more difficult to monitor, hold accountable, and keep motivated.

Pause for a moment. Just reflect on what you have read. Now put a pin in where your thoughts, perceptions, opinions, and beliefs lie. Does one of these addicts have more of a reason to be ashamed? Which one do you think would have a higher reluctance to engage in recovery work? Do you think either should be denied treatment or the medication that will keep them healthy?

Ok, now let’s turn our focus to process or behavioral addictions, which are described as non-substance related impulsive and compulsive behaviors often considered natural rewards that are continually engaged in regardless of the individuals mental, social, physical, or financial well-being (Mayo Clinic). The National Center for Biotechnology Information (NCBI) has a published article in which the evidence that behavioral addictions, more commonly conceptualized as falling on the impulsive or compulsive spectrum of disorder classification, effectively resemble substance addictions along the domains of “natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment”. The article goes on to explain that these individuals experiencing behavioral addiction have an inability to stop doing the whatever impulsive and repetitive act they are driven to do and include the responsiveness to evidence based treatments commonly used for substance use disorders such as cognitive behavioral therapies, motivational enhancement, and 12-step approaches.

Alright, now that we have some clinical, research-based knowledge, let’s talk about what these behavioral addictions are in real life. The publication will call out some of the more obvious like, gambling, shopping, skin picking, compulsive sexual behavior, internet addiction, and kleptomania (NCBI). But what I see most frequently is; co-dependency (the relationship addiction where the efforts to maintain the relationship are emotionally taxing and one-sided but feed ones self-worth), attachment issues (developed early in life but as an adult or a parent create a sense of need or dependence on the relationship or role with children, spouses, partners, friends, co-workers etc.), impulsive shopping (going out for 3 necessary items and coming back with 15 items not on the list or necessary), emotional/addictive eating (often unaware, and looks like an inability to have one cookie or eating a considerably larger amount than is necessary at any time), and chronic engagement in “over-booking” oneself (always needing to be busy, seeking seminars, workshops, retreats in the effort to gain some form of relief usually under the guise that the learning is necessary or relevant, self-worth defined by how much one does for others or is needed by others, or simply having an inability to be still and quite with thoughts).

Often, but not always, I see these lifestyle behaviors coupled with day drinking, marijuana use, and anti-anxiety medications. So, let’s say, I am a stay at home mother with children preparing to go into high school or even college. For the past 14-18 years I have been there to make every meal, watch every practice, monitor every assignment, wash every pair of socks or plate, purchase every supply. Now my child is driving, working, and making plans for moving out of the family home. They are very infrequently home for meals, no longer need me for help with schoolwork. What is my role now? I feel lost. Or what if my aging child is hanging on? Still dependent on me for all the things and I am continuing to do them. Either way I am codependent and most likely I am struggling with attachment issues and engaging in some form of impulsive, compulsive, emotionally driven behaviors that are directly tied to my need for control that I feel slipping away. The problem here is that I don’t realize that this is what is going on. Day after day I am hiding the unnecessary purchases, I am hiding the single serving wine bottles in my gym bag, I am hiding the empty container of bakery brownies or cookies that didn’t make it to the kitchen, I am constantly cleaning, I am constantly engaging in self-help learning, distracting or avoiding my emotions with a lot of activities, or worse, I have become isolated and withdrawn. What I need to realize is that my life has become a poorly functioning lifestyle, I am addicted to being a people pleaser, I am addicted to doing errands, I am addicted to being needed, I am also now addicted to avoiding my emotional needs by any means necessary in any moment.

So, let me ask you this, do I, based on these illustrations, have a warranted need for recovery work? Do I have any reason to feel shameful? I am going through a life transition that I have never experienced and unfortunately my current way of coping is not effective. Wouldn’t it be more esteem building if I engaged in a program designed to help me develop effective coping skills that will foster an improved quality of life? What if I don’t? How will my bank account suffer? How will my relationships suffer? What about my physical health?

Let’s wrap up by revisiting what we originally began to discover, taking the “shh” out of addiction. Now that you have looked at this from my perspective, the lens that I see recovery needs through, as someone that has battled everything discussed in this article, as an educated and trained mental health professional, do you see why hiding shamefully is unnecessary? Now this isn’t me saying stand at the front of your office and announce to everyone that works there that you are battling process or behavior addictions. But what I am saying is that there is no need to be shameful about a desire to seek a higher level of functioning through the changing of behaviors and the engagement in the structuring of effective life skills development.

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