“The reason I do drugs is so I don’t feel the fucking feelings I feel when I don’t do drugs”, Nick, a forty-year-old heroin and crystal meth addict says, weeping. “When I don’t feel the drugs in me, I get depressed.” His father had drilled into his twin sons, the notion that they were nothing but “pieces of shit.” Nick’s brother committed suicide as a teenager; Nick became a life long addict.
“I’m not afraid of dying”, “Sometimes I’m more afraid of living.” That fear of life as they have experienced, underlies a patients continued drug use. “Nothing bothers me when I’m high. There’s no stress in my life,” one person said – a sentiment echoed by many addicted people.
Addiction is any repeated behavior, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others. Addiction involves:
- Compulsive engagement with the behaviour, a preoccupation with it;
- impaired control over the behaviour;
- persistence or relapse, despite evidence of harm; and
- dissatisfaction, irritability or intense craving when the object-be it a drug, activity or other goal—is not immediately available.
Compulsion, impaired control, persistence, irritability, relapse and craving—these are the hallmarks of addiction—any addiction. Not all harmful compulsions are addictions, though: an obsessive-compulsive, for example, also has impaired control and persists in a ritualizing and psychologically debilitating behavior such as, say, repeated hand washing. The difference is that he has no craving for it and, unlike the addict, he gets no kick out of his compulsion. How does the addict know she has impaired control. Because she doesn’t stop the behavior in spite of its ill effects. She makes promises to herself or others to quit, but despite pain, peril and promises, she keeps relapsing.
Addictions always originate in pain, whether felt openly or hidden in the unconscious. They are emotional anesthetics. The question is never “Why the addictions” but “Why the pain?”. Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the center of all addictive behaviors. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may be entirely hidden—but it’s there. Unconditional acceptance of each other is one of the greatest challenges we humans face. Few of us have experienced it consistently: the addict has never experienced it—least of all from himself. Any passion can become an addiction; but then how to distinguish between the two? The central question is: who’s in charge, the individual or the behaviour.
The key features of substance- addiction are the use of drugs or alcohol despite negative consequences, and relapse. Drugs, in short, do not make anyone into an addict, any more than food maxes a person into a compulsive eater. There has to be a preexisting vulnerability. There also has to be significant stress, but like drugs, external stressors by themselves, no matter how severe, are not enough. Thus, we might say that three factors need to coincide for substance addiction to occur: a susceptible organism; a drug with addictive potential; and stress.
– Excerpts from the book, “In the Realm of Hungy Ghosts” by Dr. Gabor Mate M.D.
List of Addictions to substances
- List of impulse control Disorders
- Intermittent explosive disorder (compulsive aggressive and assaultive acts)
- Kleptomania (Compulsive stealing)
- Pyromania (Compulsive setting of fire)
- List of addictions – Behavioral
- Food eating
- Using computers / the internet
- Playing video games
- Spiritual Obsession (as opposed to religious devotion)
- Pain (seeking)
Exercise One: Share a story from your life, revolving around a certain addiction.
- What was the addiction?
- How did it start?
- How did it affect the addict’s life?
Exercise Two: Write a fictional story, where the main character has an addiction, that he/she feels she can’t break out of. What turn of events, changes the life of the Addict as he/she knew it?