The word “addiction” has been thrown around so much in the media and self-help resources (such as books, magazines, online articles, videos and blogs) that those who are in the helping professions often face a difficult task explaining or defining to clients what addiction really is. For the lay person who is desperately trying to understand personal or family behaviour the overwhelming amount of information available at his or her fingertips can be even more frustrating. Maybe this is part of the challenge of the information age we live in. We can all Google a disorder or a certain medical condition and seek help online, but at the same time there are so many definitions and advice out there it becomes really difficult to know who to trust and what to believe.

What makes assessment and treatment even more challenging, regarding anything addiction; is that we still have social stigmas around the word and most often people who actually do have real signs of an addiction are the last ones who want to admit they have such a problem because denial is an intricate part of the problem of addiction. This article is not an attempt to finally clarify what addiction is or to present yet another theory as to where the “root” of addiction comes from. It is more about the symptoms and characteristics that go hand in hand with any compulsive behaviour which ultimately leads to dysfunction and thus individual, family and other relational problems.

Having worked in the field of mental health as a professional counsellor for the last 10 years I have had to deal with the concept of “addiction” more often than not. The last 4 years I have also worked on a daily basis at an inpatient alcohol and drug rehabilitation clinic. What I came to understand was that some of the core behaviours of an addiction problem really seem to be universal to almost all of the behaviours we might categorize under the word addiction. Whether we are talking about obsessive and compulsive behaviours such as eating disorders, compulsive gambling, alcohol and drug abuse/dependency, sexual compulsivity, or any other phenomenon where the word “addiction” comes to mind, we see a certain number of behaviour and thought patterns which look almost exactly the same in each of the abovementioned behaviours. Here they are:

A pattern of out-of-control behaviour which repeats consistently

This pattern leads to severe consequences in some or all of the following areas: personal health (whether emotional, mental or physical), relationships (social and family), work, finances and life planning, personal development (such as education) and spiritual well-being (which include morals and values)

The individual fails over and over to stop this pattern even though the adverse consequences far outweigh the “benefits.”

Ongoing obsession or desire to control or change this pattern of out-of-control behaviour along with ongoing obsessive (and often unwanted) fantasies of the “high” or satisfaction that the behaviour temporarily provides. In fact, the harder people try to control an addiction, the worse it gets

Increased amounts of high risk behaviour just to get the same desired effect (like drinking even more to feel the same “buzz” even though the doctor warned me about my liver problems. Or, taking even more risks around sexual acting out in order to experience a feeling of love or connectedness with another person)

Using the behaviour as a means to self-medicate inner feelings or emotional pain

Severe mood swings and irritability when the behaviour or substance cannot be accessed

So the important aspect here is the consistency of a destructive pattern, not necessarily the quantity of the behaviour. Not only do we see some consistent behavioural patterns but also destructive core beliefs or patterns of thought. From the book “Facing Addiction” by Patrick Carnes et al. the common thought patterns which go along with the out-of-control and self-destructive behaviours can be described like this:

No one knows or will know the extent of my problems (I must operate in secrecy)

I can change by myself. I must isolate from others and I don’t need help

There is an easier and softer way. (For example, surely complete abstinence from such behaviours is not the solution; or entering a rehab is a bit too drastic)

As long as no one knows, no one is hurt by what I have done

I have not been hurt by what I have done

Again, such behaviours and core beliefs are common in most people who struggle with addiction. Professional counsellors who are also experienced in the field of addiction can help clients through a process called motivational interviewing to recognize the patterns discussed.

In closing, it is necessary to put out a very serious word of caution. So often people who read about addiction and who try to help are the ones who live with a family member or partner with an addiction problem. This attempt to help often becomes a mirror of the addiction process or a mirror of obsession: the addict obsesses about controlling or stopping the behaviour or substance and at the same time his or her significant other obsesses about how to control or stop the addict from having the addiction problem. The same dynamics of trying to control or stop an addiction applies here: the harder we try to control or stop our loved one from acting out, even with the best intentions, the worse the problem gets. The vicious cycle of trying to control someone else’s out of control behaviours is called co-dependency.

There is hope, but hope lies in making informed decisions. Professional help (in and outpatient rehabilitation clinics) and committed participation in self-help programs such as the 12 step mutual help meetings (AA and NA) can provide families with the wisdom and counselling to move forward. There are people who dedicate their lives to helping others with addiction problems – make use of those resources. For example, most medical aids provide a 21 day rehab option for each member per year and numerous 12 Step and other support group meetings are all over South Africa for aftercare and support once a person has completed the inpatient rehabilitation program. The reality is that psychotherapy or counselling alone has very limited success in dealing with addiction. However, combining therapy and a rehabilitation program has proven to be very successful as the client is able to look at and treat the addiction problem as well as family and personal problems related or unrelated to the addiction.

Recovery is about changing everything in your life for the better; it is not simply just about stopping the destructive behaviour pattern alone. People who think all they need to do is to stop drinking, for example, often relapse very quickly.  Personal change takes time and hard work, so a combination of rehab, joining a support group and attending family and individual counselling is highly recommended for a successful outcome.

ADDICTION – “I can choose to let it DEFINE me, CONFINE me, REFINE me, OUTSHINE me, or I can choose to move on and leave it BEHIND me”

Written by: Louis Steenkamp