Addiction is by definition: “a repetitive adverse behavior that is compulsive, obsessive and cannot be stopped”. By the behavior, I mean either using substances like alcohol, nicotine or marihuana, or mind-altering processes like gambling, playing videogames, overeating, purging or starving, engaging in sex or in risky activities or in unhealthy relationships, etc.
And yet, we all sometimes choose the same behaviors, and we are convinced that we always have a choice to whether use it or not. So, it is confusing; we may think, confronted with the addicts who argue that they cannot just stop it, that they are trying make excuses for their bad behavior. We may believe that they are just immature, too self-indulgent or morally irresponsible, and that they are trying to get away with the behavior that is inexcusable, like, for example, showing late or drunk to work, forgetting to pick up the children from pre-school, being unfaithful to their spouses, being aggressive, stealing money.
The addicts are liars, cheats and thieves, so they say, because this is what we find them do under the influence of their addiction. Now they’ll be getting off the hook for the bad things they’ve done, claiming they could not stop it. And they seem to have coned the experts, too, and convinced them that their bad behavior was a disease, something that should be treated, not punished.
To understand the important question about the loss personal choice in addiction, it is important to understand the distinction between use, abuse and addiction.
Most people have at times been drinking alcohol, trying to smoke tobacco or marihuana, eating too much sugary sweets or deciding to diet, working too much, watching pornography, loving somebody who was not good for them … They have used these behaviors to feel better, and that behavior should be considered the use. When using, they may have found out that they temporarily feel better, that the use has numbed their feelings of fear or anxiety or helped them escape difficult memories. They may have learned that using makes the troubles temporally shrink or go away and have repeated the behavior often just for the purpose of feeling better. That should be considered abuse, because you eat not out of hunger but with the purpose of numbing your feelings (… you know, chocolate makes everything seem better), or drink alcohol with the purpose to get drunk and forget the pain you’re experiencing in relationships. It’s problematic, but you still have the choice whether to do it or not.
Somewhere along the way of frequent using or abusing the behaviors or substances that have the potential to change our moods, there is a thin and invisible line of no return. There is no warning, no red lights to stop you, no definite sign that you have crossed the threshold, but once you get there, there is no turning back.
Your brain has learned to switch off the painful feelings and emotions, and what the brain learns, the brain does. Moreover, it does it automatically, without asking your decision-making center for approval. It is like those Google ads, that pop up while you are using Gmail – or it would be better to say that Google works like the brain does! It has learned your interests, expressed by your frequent use, and offers them automatically. This means that your ability to choose your behavior (or Google without the ads), has been seriously compromised, and will stay so no matter if you want to stop it. You’ve crossed the line to addiction.
How do you know that the line has been crossed, or that you are coming near, so that you can stop in time?
Sure, there are warning signs, like forgetting what you did the night before under the influence of something, obsession about your drug of choice, constant thinking about it, having to use more and more for the same effects … But the problem is – you won’t want to stop it, so you will deny the problems and argue with anybody who would try to talk you out of it. In spite of your efforts to conceal the symptoms, everybody else will know you have a problem before you will. And if you live with somebody who loves you, their warnings and requests that you stop are a sure sign that this is no game to play anymore. You will argue that you can stop anytime, but when you will actually try to stop, you will find that you can think of nothing else. Your body will be in stress, you will feel terrible anxiety, and the only thing you will be able to think of to stop that terrible withdrawal feelings and feel close to normal, will be the next use.
Addiction is a disease characterized by the inability to stop adverse behavior, even if you want to stop it and have tried to stop it a number of times.
As we have said, it has something to do with the brain. Our brain is a beautiful delicate organ, that enables us to think, feel, perceive our surroundings and experience our inner thoughts, all wrapped up in a common experience of “I AM!”. There are the functions of rationality, choice, spirituality, morals, and they are generated in the brain prefrontal cortex, the grey layer of nerve cells that are our highest neural regulator. But the brain does more than that: it automatically controls all the delicate workings of the body, and it does so without our conscious effort. We do not need to think for our hearts to pump or our stomachs to secrete the juices. There is a large part of the brain that controls all the vital functions of the body, concerned with survival and it is called the brain stem. And, located in between the two, is midbrain, the area with neural nuclei where emotions are felt.
All these areas work together in harmony and are orchestrated by pathways that run between them. There are pathways that convey sight, others that convey auditory sensations so we can hear, and there are some pathways running between the three areas that convey pleasure and reward, and these are the ones that are impaired in addiction. In a non-addicted person, the prefrontal cortex, our rationality, exerts top command over the lover centers. In the addict, the top command has been compromised and hi-jacked by lower centers. Even if the addicts rationally know that it’s bad for them, the emotional and survival parts of their brains take over and argue that the drug is necessary for survival and emotionally important. So, it is a fact that by just willing to stop it, the addicts, cannot permanently stop their harmful behavior.
Still, there is the good news, one that is demonstrated by recovering addicts around the world every single day. Addicts can stop, if they really want to and if they adhere to the therapeutic programs, designed to help them overcome their disease. We are going to talk about them in our next blogs.
Check out my video on this topic here:
Sanja Rozman is a medical doctor, psychotherapist and author of 8 books on behavioral addictions.
Read more in her book Serenity: How to Recognize, Understand, and Recover from Behavioral Addictions
that is about to be published by Brandylane Publishers Inc., Belle Isle Books.