— Derek Littler (@methadoneUSA) July 21, 2016
Have you ever wondered why you keep drinking, gambling or engaging in compulsive behaviour when you know it’s causing calamitous difficulties in your life and in the lives of those around you? Have you wondered if you have a bad habit or even – hold your breath – an addiction?
I’m going to speculate that your answer is…“Yes, I’ve wondered countless times and I still haven’t figured it out.”
Let’s consider a question or two to help you make sense of the senseless.
What happens when you first think about your substance or behaviour?
When the notion of using a substance or engaging in a certain behaviour first occurs to you, do you feel a pull toward the idea that is very pleasurable? Do you suddenly feel energized? As your anticipation grows stronger, do unpleasant feelings like anger, boredom, fear or loneliness begin to fade away?
If you answered “yes” to this question, you have your first clue as to why you keep repeating problematic behaviours despite getting into trouble with yourself and others, time and time again and why it’s a good idea to begin to consider how habits differ from addiction.
Habits don’t generate feelings of need – no anticipatory energy, no urge to jump right in. A habit is a routine action of any kind that you repeat on a fairly regular basis. The costs and benefits are about equal. Habits can be good or bad.
Addiction, on the other hand, is a relentless urge. You crave it even though experience has proven time and again that partaking of the experience is equivalent to lighting the fuse of a bomb. The resulting explosion of negative consequences will cause suffering to yourself and others. The costs are much greater than the benefits. An addiction feels wonderful in the moment but the rest of the experience is downhill. There are very few “good” addictions.
When does a habit turn into an addiction?
Behaviour can be quantified. It’s a matter of degree – one drink or ten, one bout of reckless spending or many. What is the extent of the behaviour?
We can measure the degree of the behaviour on a continuum or scale.
It might look something like this.
Now let’s imagine at the 1 end, not much is happening and as we move along the path to the 10 end, the behaviour we are measuring is getting bigger, stronger or more intense.
Let’s measure the behaviour of, say, drinking.
One drink is very different than ten. Gaining one pound is less significant than gaining ten or twenty pounds. Let’s look at it the other way around. Traveling down the scale from having five drinks in an evening to one or two represents a big change in drinking behaviour. Traveling down the scale from being ten pounds overweight to only one pound is a change any dieter would celebrate.
Continuums flow back and forth. You can travel up the continuum from 1 to 10 or down the continuum from 10 to 1. And, of course, you can use any set of numbers you like.
How you feel about the behaviour is incredibly significant in terms of future decisions you might make. If you really like the behaviour or feel you need it, chances are good that you’ll travel up the line – from one drink to, perhaps, four or five.
If the behaviour is so-so or ho-hum, chances are good that you’ll travel down the continuum. Instead of washing the dishes three or four times every day in order to keep your kitchen neat, you might decide that once would be sufficient.
The benefits, real or imagined, are important in your decision-making process.
What is the strength of your desire or need to engage in the behaviour? How desperately do you want to do it?
Is it a take it or leave it relationship or do you feel a compelling need to engage in the behaviour? Is it an “I must have it” – “I must do it” relationship that is growing stronger, more powerful every second as you consider it?
At the lower end of the continuum, the behaviour (using or doing) is occasional and probably, appropriate. There is no intense relationship developing – no feeling of needing – that keeps growing stronger? This is the territory of habit.
At the mid to upper end of the scale, extreme desire and an intensely powerful pull has developed between you and your behaviour. Wanting or craving it keeps driving you to continue despite any negative consequences that might occur. It feels as if you’re out of control, as if you’re powerless over your own choices and decisions. And of course, dear reader, you are not out of control. It just feels that way. Endlessly giving in to the temptation could be a set up for addiction.
- A habit is a routine pattern of behaviour that doesn’t generate a feeling of need or craving.
- An addiction is a behaviour (using or doing) that is relentlessly persistent. Craving is intense and you begin to justify the benefits and deny the costs. Negative consequences damage your life, health and relationships.
Habits reside at the lower end of the continuum. Habits do not generate a life or death need to continue or escalate the behaviour – no overwhelming desire.
Addictions, on the other hand, cannot exist without craving, that feeling of overwhelming need. These behaviours exist at the mid to upper end of the scale and wreak havoc in your life.
It’s really important to note there is no magic spot on the scale that shrieks “addiction”. The point of no return does not exist. Your own actions and the resulting consequences, positive and negative, provide all the information you need as to the state of your relationship with a substance or behaviour.
We are all creatures of habit: brushing teeth, getting exercise, going to work, being on time, etc. Forming habits is a normal and necessary behaviour of humans. Routine habits add structure and shape to your life. They reflect your pattern of day-to-day living. You don’t feel an overwhelming desire to engage in these daily habits, you perform them as a matter of routine from which you derive some measure of benefit, if not distinct pleasure. Habits don’t exact extreme costs. You might not like a habit very much but you feel it’s a worthwhile or necessary routine and you’re willing to continue – preparing your tax return, for example. Your relationship – the intensity of your desire is low.
Let’s consider one or two examples.
Keeping your body strong and healthy through good nutrition and exercise is an excellent habit. The benefits are many, the costs very few. Some days it’s tough getting started on your program but you feel good about yourself when you’ve finished. There’s no reluctance to stop. There’s no craving to begin again. A normal habit.
Feeling compelled to work out at the gym five times a day because you feel a kick of pleasure and positive expectations as soon as you think about the gym is not a normal habit. As soon as craving comes into the mix along with negative consequences, addiction is present. You feel an overwhelming compulsion to go to the gym well beyond doing so for health or fitness. An extremely strong relationship between you and the activity has developed. I know of one individual who had to make nine trips to the gym daily. Despite the fact that he had virtually no time for anyone or anything else, he still insisted that without this pattern of attendance his health would suffer. Just imagine what other areas of his life were suffering because of his extreme need to go to the gym the prescribed number of times.Purchasing needed items for the home and family is a normal, day to day behaviour, a necessary habit.
If your home is in mortgage default and you’re facing bankruptcy because of your needless spending behaviour but you keep on doing it anyway because you feel driven to escape negative feelings regardless of the costs to you and your family, we can say quite certainly that this behaviour has gone well beyond habit. The shopper is driven and gets a kick – a high- from acting on the preoccupation of shopping. Craving the activity is present. Negative consequences have almost taken over this individual’s life.
Remember, the power of the relationship and the necessary step of giving in to it is what drives the behaviour despite any negative consequences that may follow. The behaviour feels like it’s controlling you, not the other way around.
The Continuum is not static. There is movement up or down, as has been said.
Let’s consider another few questions.
- Which direction, up or down on the continuum do you think would be more difficult to achieve? Why?
- Where would you place the addiction point on the continuum? Why?
- What is the agent that propels someone up or down the continuum?
Let’s see how you did:
- Down is the more difficult direction. Remember, it’s about the strength of the relationship. You have an intense relationship with the behaviour. The craving urges are so strong that you continue to engage in the behaviour despite mounting negative consequences. Working on your own to change your behaviour might result in damaging your level of confidence if you keep going back to the behaviour time and time again. I often hear people say; “It’s no use, I’ve tried to quit a thousand times.” There are evidenced-based techniques that have proven very effective in instituting and maintaining behaviour change effectively and quickly.
- There is no discernible point on the continuum at which we can say you have crossed over a line into addiction. Neither can we say definitively that you have crossed the line out of addiction territory unless your behaviour has moderated to an appropriate level and you’re able to maintain it, with or without some level of difficulty. You are an individual. You are not stamped out as an identical widget to all the other widgets. After getting some help, an individual brought his level of engagement down from a 9 to a 2. This represents a very successful change in the problem behaviour for this individual. Whether he or she stays in the moderate range remains to be seen. There are no guarantees that the behaviour won’t escalate again. Most people feel better about their chances of maintaining their positive changes if they follow a few strategies that guide them safely along.
- The agent that propels change in an upward direction is positive expectations and need. You feel you need the drink, gambling or shopping behaviour and you expect it to be a positive experience. Conditions such as stress, conflict, isolation, boredom and many other emotions can cause habits to escalate. We all seek some expression of comfort when we are hurting; a drink, a quick trip to the mall, another piece of cake or an online game of poker seems, in that moment, an innocent diversion. But a habit can become an addiction if it is used excessively and persistently to cope with situations or intense emotions. You seek comfort in what you know. But if what you know is also causing harm, it is time to learn a more effective and healthy coping strategy.
Small changes in your placement on the continuum are happening all the time in your life. You only notice it, (or others notice it for you) when the behaviour in question is escalating due to cravings. Negative consequences begin taking a toll. When this happens, craving is driving the bus. Or perhaps what’s noticed is a lessening of the behaviour. Negative consequences are no longer an issue and cravings have become much less intense. In this case, you’re driving the bus and it feels really great.
The agent propelling you down the continuum is once again need – a very different need than above. You recognize you’re in very serious trouble and understand even bigger, more costly consequences will result if change, however reluctantly begun, is not accomplished. The need for change in a downward direction calls for persistence, a high degree of motivation, a belief that it is possible, compassionate support and a therapist to help you acquire the skills and strategies to expedite the process in a timely fashion.
The behaviour loses its power as you move down the continuum to a moderate level. The relationship is no longer extreme. It has lost much of its intensity.
Our Key Point:
It’s the relationship you have with your behaviour of choice that determines its frequency, quantity and duration. How powerful is the desire for you to have it or do it?
But, and it’s a big but: You are not powerless.
Always remember, if you don’t give in, the cravings and urges will lessen over time.
If you do succumb to the desire, the next time craving rolls into your awareness, it will be bigger, stronger and more difficult to resist.
Take it or leave it experience – no craving, no escalating negative consequences — no problem. This is a habit, good or bad, but not an addiction.
Must do it/must have it relationship – severe craving, many negative consequences — big problem. You are engaging with your behaviour of choice at the upper end of the continuum and you are flirting with addiction.
Bottom line:” If I must have this experience regardless of the negative consequences, at any price to myself or others, because of the craving, I must say addiction is a strong possibility”
Do you remember the question that was asked at the beginning of this article?
“Why do I keep drinking, gambling or engaging in other compulsive behaviours the way I do even when I know that it’s causing calamitous difficulties in my life and the lives of my family members?”
Our Answer :
“You behave the way you do because craving is driving the bus. Even though you feel desperate and guilty about the behaviour, you feel compelled to engage in it. You give in. As a result, craving builds and the negative consequences continue.”
By using a continuum, a simple up and down scale, I hope you can see that habits and addictions begin life as a single entity – a habit. But the rate of the behaviour can move along the continuum in either direction, quickly or at a snail’s pace.
Addiction is no longer thought of as a static entity – once you’ve got it, you keep it for life, as was once believed Habits and addictions are subject to change just like everything else in this wild world of ours. Just because habits and addictions CAN change, doesn’t mean they WILL change. Habits can stay habits for life with little change. And as sad as it is to think about, some people might choose to do nothing about their problem behaviour and remain addicted.
Perhaps you’re already pondering an obvious question, namely:
Why Aren’t Negative Consequences Enough to Instigate Change? How Bad Does it Have to be Before I Kick My Butt into Gear?
What You Don’t Know About Habits Can Add Up To Addiction was originally published on www.MethadoneClinicUSA.com
Imagine you’re taking the bus to work one morning. You just happen to hear the two people behind you talking.
Person A – “Did you hear about Janet? What a nightmare for her family!”
Person B – “I sure did. It’s the talk of the whole office! You know her dad’s an alcoholic, right? So it’s no wonder Janet is too.”
Person A – “Yeah! No wonder. I heard they’re trying to talk her into going away for treatment, you know, rehab. It’s a disease. You’ve got to go to rehab to get the treatment.
Person B – “I heard Janet’s still in denial and everyone at home is fit -to -be -tied about what to do. I saw “Intervention” last night. That’s what she needs. Just get in the limo and go. I bet she won’t go.”
Person A – “I’m glad no one in my family has ‘it’. Jeez, the genes you’re born with sure can wreck your life.”
Aren’t you glad your office is just ahead?
As a culture, the above dialogue is still pretty much what we hear, believe to be true and perpetuate. In other words, addiction is a ‘disease’ and as such requires a medical intervention – ‘treatment’ at a medical ‘rehabilitation’ centre. I hope to broaden your knowledge base considerably so the next time you hear a conversation like the one above, you will be able to intervene with some sorely needed facts about the causes of addiction.
What Causes Addiction?
Addiction results from a complex interaction of physical, emotional, social, and environmental influences. The combination of factors is different for everyone. It’s important to stress that addiction is never the result of a single factor, say, biology, alone. As the factors at play in an individual’s life vary, so does the level of risk. In other words, the conditions which combined in one person’s life and later resulted in addictive acting out are, undoubtedly, different from the factors that will put someone else at risk.
What Are These Individual Factors that Interact?
- Genetic vulnerability plays a small role. Biology can never, by itself, explain addiction. It’s worth repeating, addiction is complex and multifaceted. If addiction was present in the family of origin, do the siblings begin drinking because of their genes or because they were raised in a hard-drinking household and simply believed their lifestyle reflected normal family life? If one child in this family remained abstinent for life, to what do we attribute this? It becomes the “nature versus nurture” debate, or, if you like, the “Which came first the chicken or the egg?” debate.
- One’s emotional well-being, social factors, and past learning experiences all play a significant role. Social learning is considered a very important factor in addiction. It includes patterns of use in the family of origin, peer pressure in adolescence and advertising or media influences. Think about emotional well-being for a moment. Doesn’t it make sense that the more mature, resilient, socially connected and capable you are, the less vulnerable to addictive acting out you will be.
- Personal characteristics: The qualities that make you the person you are – interact with the people, events and day to day stresses of your life. Perhaps at one time having a drink, gambling or shopping made you feel more positive, less anxious and fearful, more in control. If having that drink also contributed to increased feelings of confidence, attractiveness, assertiveness and vitality, it’s entirely possible that enjoying the experience predisposed you to repeating it at the next opportunity. We can all relate to the idea of repeating what we have previously enjoyed or found to be positive in our lives.
- Increasing involvement, (More using it/doing it). Perhaps you began to experience a need to stay involved with the substance or activity for longer periods of time. Perhaps you found yourself reaching out for your substance or activity in a greater number of stressful or social situations. Before long you arrived at a feeling of not being able to tear yourself away regardless of your responsibilities. You began looking forward to it and searching for more opportunities when you could justify it.
- Addiction occurs: The substance or activity becomes your habitual response in almost every situation. Negative consequences begin to accumulate in your life.
The behaviour that once seemed to support you through many of life’s experiences begins to turn against you. Without it, you experience craving. Unpleasant consequences begin in accumulate in your life.
What Are the Distinguishing Features of Addiction?
People frequently argue about who is addicted and who might just have a problem. How can you tell for sure?
Quick Answer: You can’t. This is one of the consequences of the disease or medical model. If you have a problem, you don’t have “it”- the disease. It has become a black/white, you’ve got it or you don’t issue. If you have “it” then treatment at rehab and lifelong abstinence is your only option. You will have “it” for the rest of your life. Problems, as we understand the common usage of the word, can be solved. This is one of the reasons people so fear the label of being “addicted.”
Just before we go over the distinguishing features of addiction, I feel it’s important to note that the greatest amount of damage to life, limb, productivity and personal contentment in our society is caused by those who “just have a problem”. Sometimes we get so caught up in absolutes, in black/white issues, we don’t see the forest for the trees. It’s not the label, it’s the behaviour and the negatives adding up in someone’s life that we need to pay attention to.
Several of these features will be present with addiction. Remember, we are individuals. People have different features of the disorder.
The urge, the craving, the overwhelming need, to engage in the behaviour whether it be using alcohol, drugs, gambling or any other excessive behaviour.
Preoccupation, Obsession or Fixation:
The individual can’t stop thinking about the behaviour. It battles with thoughts that reflect his or her better intentions, but eventually the urge to engage in the behaviour rules the day.
Despite every intention to stop or cut down, the behaviour happens over and over again.
The individual has experienced many negative consequences when engaging in the behaviour. Employer threats, family quarrels or breakdown, legal and financial hardships, tremendously embarrassing or endangering situations to self and others, all fail to bring about lasting change.
The “This time will be different” refrain leads the individual into yet another repetition of the same old pattern.
“Just one or at the most two” is heard over and over again. An individual may be able to control the behaviour in certain high demand situations like having dinner with the employer, but he or she can’t guarantee it 100% of the time. Usually it’s a no-win situation.
If you’re measuring your own behaviour by the above list of telling behaviours, make sure you’re being scrupulously honest with yourself. This is the time to stop rationalizing, minimizing and denying your behaviour. What others are telling you is true.