As a high majority of clients I see have problems with smoking, drugs, eating, drinking (alcohol) or even Obsessive Compulsive Disorders (O.C.D.), I decided to write on this subject subject for the SNHS Reading Room

So What is Addiction?

Addiction, as typically defined, is a reliance on a substance or behaviour that the individual has little power to resist.  Some doctors describe addiction as 'a brain disease' and 'a chronic relapsing disease', where there are visible alterations in the brain and are long-lasting within their neurological patterns.  Other doctors describe addiction as an emotional and behavioural disorder, where the individual has been subjected to an emotionally deprived or unstable environment. The nature and the very existence of this ‘trait’ are still actively debated in the medical, neurobiological and psychology communities.  Whether there are definite implications in the brain that contribute to addiction, whether due to genetics, environmental stimuli or a mixture of both, still needs to be properly addressed.  While no one has succeeded in proving the existence of a true addictive personality, many experts now believe that the predisposition to addiction is a combination of biological, psychological and environmental factors.

When describing addiction it is important to address the types of addiction and substance abuse that are often accredited to the addictive personality.  There are two primary forms of addiction, one being the substance-based, the second being behaviour-based.

Substance Based Addictions involve a dependence on prescription and recreational drugs including alcohol and nicotine.  Narcotic addictions are more easily explained and identified neurologically. Particular drugs, such as crack and heroine cause massive surges in dopamine in the brain, with different sensations, ranging from invincibility and strength to euphoric and enlightened states. Use of these substances almost immediately changes particular aspects of the brain's behaviour, making most individuals immediately susceptible to future abuse or addiction.

Many drugs act as pain killers. They kill physical and emotional pain. A person may start using drugs or alcohol to numb pain, leading to addiction. People addicted to prescription pain medication are simply trying to numb pain. To a young person, boredom may be mentally and emotionally painful, and the drugs provide relief and escape from that pain. Being unable to communicate well so as to solve relationship problems can also be painful. Stress can be painful, not to mention losing a loved one. So pain can make anyone susceptible to addiction.

Drug cravings stem from residues accumulated and stored in the user's fatty tissue due to earlier drug use.  A common falsehood being promoted to youth is that marijuana, for instance, leaves the body in 30 days. Marijuana may not show in a urine analysis several days after use, but its active ingredient, THC, stores in fat tissue. Exactly the same thing is true for other drugs, including alcohol, nicotine and prescription drugs. These drug residues can get mobilised due to stress, physical activity, weight loss, etc. and get back into the blood stream, triggering physical cravings.  That's when the addict, who has just promised to quit, runs out and gets more drugs.

Behaviour Based Addictions are also common. Many people are addicted to activities such as gambling, shopping, and eating. These addictions are not as easily explained neurologically, but are generally included in the addiction susceptibility characterised by the personality trait.  Even though it is not obvious how it happens, it still does create a desire to thirst for the high that they produce.  Someone with an behavioural addictive personality doesn't usually do things casually. Rather they become obsessed with it and need to do it just to feel good. For example, if someone is addictive and they like exercising, they will go to the gym, every day, no matter what the pain.  If they can't get there, they are angry with themselves (this also applies to drug addiction).

Combined Addictions are also common.  These addictions include both substance and behavioural aspects.  A typical example is the addiction to nicotine (either smoking or chewing). This particular addiction combines a physical addiction to nicotine and a mental facet, the repeated routine of the behaviour, such as a cigarette after meals.

So addiction can be related to the association between the substance and the behaviour.  The end goal is always happiness and pain relief, they both seem to come hand in hand. Unfortunately the achievement of these goals is usually short lived.  People with addictive personalities are using their addictions to cope with life because they are uncomfortable with their strong emotions and they have not discovered other ways to soothe themselves in times of crisis. Often when they are able to give up an addiction they will substitute it with another more socially acceptable one.

Another issue interestingly related to addiction is the relative relationship between addiction and gender. A collection of classic studies have shown that males are statistically more susceptible to Substance Based Addictions while females are more susceptible to Behavioural Addictions.

Apparently male adolescents were found to be more active in early drug and alcohol experimentation and men in general are four times more likely to become dependent on alcohol, twice as likely to routinely use marijuana, and one and a half times more likely to become addicted to cigarettes than are females.  Conversely, women far outnumber men in addictions to eating, binging and purging, thus developing eating disorders at a greater rate.

The variances in the addictions of men and women are often traced to societal values and the images presented to young men and women.  However the trend seems to be shifting with women becoming more at risk of developing problems with smoking and binge drinking. This could be due to the blurring of gender roles within modern society today.

At this point I would like to add some information I would consider important about hereditary conditions. It has been shown with other diseases, cancers and genetic traits that particular disorders favour one gender over another, therefore these statistics may show an interesting aspect of the genetic or neurobiological nature of the inherited trait.

As children we are a hive of learning receptors and we copy things others do in order to develop ourselves.  The people we mostly come into contact with are our parents. So if the parent who is dominant in an individual's life, acts and reacts in a certain way to situations (such as stress), the child will learn to respond the same way.  Therefore, if the parent has a heart attack due to poor coping strategies, then the child has a much greater chance of following the same path. Monkey see monkey do, to put it into a nutshell.

There are two main theories as to why people have addictive personalities:

1) the brain is either diseased or genetically disordered. If the brain was either diseased or genetically disordered to a point where control of actions are inhibited, then the body would go for the things that would make it feel good, such as drink, drugs and food to name but a few, and would have no control over actions being taken what so ever.

2) the person has an emotionally starved mental state. If the brain has been starved of affection during the beginning stages of mental development (from birth to puberty), then the person's natural level of endorphins are low. This leads to a low level of self-esteem and poor self-image.

I personally believe that the 'Addictive Personality' evolves from earlier life environmental factors, even as far back as the very first stages in life outside of the womb. (Some people argue that it begins inside the womb). People inherently need to feel good about themselves and their environment.  Addictions are often traced back to problems with depression and other emotional distress.  So you can often start to notice a pattern developing between these individuals’ neurological make-up (i.e. from birth to now) and the actions taken by them in everyday life.

For example; if a child is not shown enough affection, he does not acquire the correct skills needed to create the happiness he desires. This lack of love creates a hole in the child’s life. The child does not know how to fill this hole with natural self-worth and has to resolve it with whatever seems to 'do the job'.  He or she will probably start off with high sugary snacks, a substance based addiction, or maybe Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD),  behaviour based addictions.

ADHD/ADD usually starts off with the child not getting enough attention. Possibly he or she gets five minutes praise for a good painting, but gets an hour's attention for doing something bad. (Some would use this as evidence to support short, sharp shock punishment, a five second smack, rather than just talking to a naughty child). So the child then learns to act up just to get attention. I am not saying the child does this on purpose, but will naturally go with whatever works. Often sufferers of this syndrome find it difficult or are even unable to finish tasks. This is because of the boredom factor when there is nothing to do. If there are things left unfinished everywhere then there will always be something left to do. In fact the inability to deal properly with boredom can be another factor leading to addiction.  They require something to capture their attention.

Obsessive-Compulsive Disorder (OCD) on the other hand is due to the lack of control the client feels they have within their life and the only thing they can have control over is their own actions.  So they focus on these in different ways such as for instance, making all the tins within their cupboard face the same way. O.C.D.'s are usually very common within the 'ADHD/ADD system' as suffers already lack the feeling of control within their lives.

If a child doesn't get enough love and attention in his or her life from the start, further problems are quite likely to occur and may stay with the child throughout life, even through adulthood, unless properly treated. Imagine the notion of giving your child drugs to sort the problem. Showing the child that medication is the way to sort out problems seems rather illogical, especially when all the child needs is affection and appreciation.

Methylphenidate (also known as Ritalin) is an amphetamine-like prescription stimulant commonly used to treat ADHD in children and adults. It is a bit like 'cocaine for kids'. It works because it is creating the happiness within the child's system that he or she requires, thus stopping the need for attention seeking.  It is treating the symptom rather than the cause. With the individual entering adulthood, still lacking the needed skills for creating internal happiness, they must find other sources to give the body a substitute for what it needs. This is where the addictions take hold and the body adjusts to suit the incorrect input. The person experiences severe mood swings caused by the body's unbalanced state.

The situation gets even worse when relationships start to take place. The usual relationship here is an excessively co-dependant one. Of course we all have mutual needs with our partners.  We stay together in happy loving relationships because these needs are being met, and separate or divorce when they are not meet.  However the suffering individual begins to need the partner to supply love at an unmanageable level, trying to fill the still present void within their life and becoming reliant for the partner to create meaning within their life. As they are constantly struggling with the need for the feeling that love creates, they keep falling back on the artificial input they get from substance or behaviour. 

The problem boils down to the association the individual has with the addicting model their mental make-up has created. Dependence on the substance or behaviour stops the person searching for the correct means to satisfy their needs. The more this occurs, the higher the probability of permanent psychological, neurological and biological damage happening, thus giving the effect of a disease. With clients coming to me with problems related to these addictions, the underlying problem is usually depression and self-hate. It is normally the case that the client is taking anti-depressants to try and re-balance the body's system, but as earlier stated, taking drugs in this situation is unproductive and not confronting the real issues. It is metaphorically like keeping a plaster on a cut all the time. The wound needs to heal by getting air to it.  If you keep the plaster on, the wound will begin to turn septic and create even more problems.

Using Psychotherapy and / or Hypnotherapy to Help With Addictive Disorders

With using Hypnotherapy, it is first best to disassociate the client's bond with the addiction from the bodies 'memory' of the result it creates. This is done, whilst in hypnosis, by putting the client in a role situation where they would usually go for the routes of the addictive path. For example, enforcing the damage that the behavioural/substance addiction is doing their life and body, and then to associate the natural good feeling you can get from achieving the needed goals.

Under hypnoses the client is made aware of how unhealthy they will become if they you continue with the addiction and how happy they will be when they conquer it.  The main reason for the initial disassociation, usually in minor cases, can be a rapid recovery from the problem. This is down to the possibility of the memories related to the substance/situation.  Sometimes when the person is doing this type of activity there are associating the way they felt with a particular situation and are just trying to regain that euphoric feeling. Their body and mind remembers the feeling they had when taking or/and doing the activity.  They are on a never ending search as it is just the situation, probably the company and timing that created the feeling and not just a single factor. This is why we sometimes find basic suggestion therapy exceptionally successful, while at other times it will not even make a dent on the 'addiction'.

Psychotherapy techniques can be used to analyse the client's life to find out where and when their feeling of unhappiness occur and to come up with a plan on how to re-evaluate the approach they are taking in their everyday life.  For problems like addiction it is best to remind them that it is going to be an un-even path to reach their goals as many years have passed with their body acting in a certain way.  Such a person may have walked a self-destructive path all their life and caused many problems throughout their body. When changes occur it initially feels uncomfortable and may be painful.  The body needs time to adjust to the new conditions.

Try and imagine a tank of water, with a filtering system that only filters the top half of the water and at the bottom is the sludge and slimy residue. The sludge and slime represents the unresolved issues within their life. When we make a change, we stir up the water and the residue begins to make the water cloudy and dirty. You start to remember back to when the water was partially clean with only the bottom half is dirty. ‘It was better when the water was like that, at least I had some clear water, now I don’t have any!’ This is the comfort zone becoming apparent. It is important to realise that it takes a while for the filter to start showing an affect, but the more time passes, the more clean water there is.

 If you let the dirt to settle again by going back to your comfort zone it will take longer to start up again. Or it might settle again and you never want
to stir it up again due to the fear of it clouding up the water again.  So once you start, keep going and you will slowly notice the difference and over time you will notice a big difference from when you started. Sometimes people might be addicted to something, but appear to have it under control. The reason why the addiction is missed is due an outside factor creating a resistance. This usually comes in the form of fear, the fear of the damaging effects it might have on family, friends or work and can be missed as just recreational use.  This is why people usually move their addiction on to something more palatable, but occasionally returning to the original problem when no-one will be able to find out.

Conclusion

My conclusion puts forward the notion that when the brain is young (before the age of 11 or so) it is 'pliable' and can change to suit its environment effortlessly.   However when the brain becomes 'set', or 'cured' in chemical terms (past the age of approximately 20 years of age) it is increasingly difficult for it to adjust to different situations or learning opportunities. Between the ages of approximately 11 to 20 the brain is in 'mid setting' and this is the time when help may be crucial.  During the period it is still possible to create life lasting changes to the young person's mental make-up or
neurological pathways.  After the age of twenty it may me much harder to bring about lasting change. Even though changes can be made to the behavioural patterns of an adult, it just takes a lot longer, and needs increasing amounts of time the older the client gets.

As the evidence appears to be pointing towards a 'brain dysfunction' of some sort, it would be unethical not to delve in deeper to the myriad of the 'addictive personality' further. As the symptoms the brain shows could point towards a disease of some sort, has it always been that way? Did the brain begin with a defect or was the defect or imbalance caused through life's experiences? I believe that in most cases the problem starts out as something emotional and has taken its toll on the body creating an imbalance within the brain. So what started off as something simple to correct has been made almost permanent because of lack of understanding and wrongly placed trust in the notion that a pill is the answer.

So further down the road of 'addiction' it could be a self-created disease, but it is also in the beginning just a simple lack of proper training within youths today (education rather than medication, emotion not a pill).  Within the earlier years of addictive personalities, both the parents and the child will need to be treated. The most blatant signs of childhood addictive personalities (like ADHD/ADD) are major temper tantrums or most excessive behavioural patterns. There is no real need to allocate blame for the situations we find ourselves in. We just have to recognise our responsibilities and strive to make things better.

Outside or third party factors may be needed to help the client recover and change. As with most, emotional issues, the client is reluctant to open up and talk about their problems, and exactly how they are feeling and how it affects them and their life. The chemical imbalance in the brain is a physical manifestation of the clients’ mental and emotional state. When the body is sick the mind suffers, and it happens the other way round too. The most obvious cases are stress causing heart problems, strokes, IBS and stomach ulcers, and even the less obvious ones such as cancers. The chemical imbalance seen by scientists is the body practically at war with the mind.

All there seems to be is fear, fear of failing, fear of success, fear of loneliness, fear of knowing too much, fear of knowing too little, fear, fear, fear. Gathering the courage to gain control of the problems that govern society today will create better solutions and greater understanding of the body and mind relationship. Using a pill to solve the problem is not only a delaying tactic, but a misguided quick fix solution for an impatient society. As Einstein said "The answer to everything is a simple one", so maybe addiction could be solved by talking.  Who knows? All I know is that the current 'solutions' are creating more problems than they solve and are becoming less and less efficient.  So in the words of Winston Churchill, "We have nothing to fear, but fear itself".  So lets gather up the courage to try a different approach in attacking addiction.

Bibliography

Feel the Fear and Do it Anyway - Susan Jeffers

You can Heal Yourself - Louise Hay

The Art of Happiness - The Dalai Lama

Ethics of the New Millennium - The Dalai Lama

Theory of Addiction - Robert West
 
12 Effective Ways to Help Your ADD/ADHD Child:
Drug-free Alternatives for Attention-deficit Disorders - Laura Stevens

Brain Dependence - Marybeth Curtis