The Seduction of 'Addiction' Language
Does being an 'Addict' mean you get a free pass?
Posted Mar 12, 2012
While it hasn't reached shelves yet, Dr. David Ley's book The Myth of Sex Addiction has certainly garnered a lot of pre-publication press. My guess is that it will be good fodder for conversation in a world populated by celebrities who are seeking treatment for sex addiction, and for clients and therapists around the country who are dealing with this sort of issue (and Dr. Ley's take on it).
What I find more interesting is the way that the term addiction is thrown around. Sex Addiction, Food Addiction, Video Game Addiction, Caffeine Addiction, Coupon Addiction. You name it. If there is a chance something can be indulged in or consumed, someone will claim they are addicted to it. TLC even has a television show title, My Strange Addiction (with episodes on growing toenails to eating toilet paper). But should the language of addiction be used? Is there a better way to describe the patterns of behavior that many people find themselves in which can have such devastating consequences. Gamers who neglect their children and spouses so that they can play for hours on end, problematic eating that threatens someone's health, a coffee habit that creates a financial burden, or a couponer who hoards toilet paper becuase it was this week's deal at the grocery store and makes their home a pantry on steroids - are they addicts?
Certainly there is cause to examine behavioral addictions, such as gambling. But is the term addict being used in a cavalier manner? Here's a few terms to reconsider using:
Use vs. Misuse vs. Abuse
Let's suffice it to say that Use constitutes whenever something (i.e. a drug) is utilized to meet some need. If whatever it is happens to be the best way to meet that need, then the term use should be used (no pun intended).
Misuse constitutes whenever something is utilized to meet a need, however it isn't the best solution to meeting that need. Think of the person who might use ibuprofen to promote muscle growth. Ibuprofen is a drug that is a pain-killer, not a muscle builder. This would be misusing the drug.
If, however, the use of something begins to cause damage to the body or a person's life (like a family relationship or at their workplace), the presense of this damage would consitute Abuse. Something bad is happening because of the way it is being utilized.
Can video games be used to promote cognitive skills? Certainly. Could coupons be used to save money on your grocery bill? Without a doubt. Many things have varying levels of potential of abuse. Alcohol is one example. Alcohol can be used, misused and abused. Not everyone who drinks alcohol is an alcoholic. Some things have the potential to be used, misused and abused. Drugs of abuse have their abuse and addictive potential based on their ability to activate the brain's circuitry and neurochemistry which underlie the natural reward mechanisms. The level to which a drug can activate these systems is what determines their abuse and addictive potential.
Addiction looks an awful lot like abuse, but it often has the added elements of craving, increasing patterns of intake, and an inability to stop. It is this inability to stop that is often referred to when absolving someone from responsibility (moral and/or legal) in many circles. The addiction is appealed to as the source of the problems in the person's life. The person is no longer in control, but it is the addiction that controls them. Often this starts off as abuse, but escalates into addiction. The body begins to rely on the drug to function properly and a dependence develops. for addicts the inability to control themselves is where psychologists realize that the brain has been hijacked and the person's level of agency is markedly reduced. It is here that the language of addiction can be seductive for so many. The label 'addict' could be adopted in order to reduce a person's accountability. While warranted in many cases, we have to be careful that it is not misused or abused.
Dependence is when something is needed in order to function properly. There is physiological dependency - where the body has begun to rely on the substance - and psychological dependency - where the person has psychologically begun to rely on it and they think they need it (even though they are not physiologically dependent on it). Dependency does not always constitute addiction. For example a person may become dependent on pain killers, but they may not crave them. When someone becomes dependent on something, in its absence they experience withdrawal.
Impulsivity is a pattern whereby someone has a thought that they act on without reflection. Often characterized as a whim, they follow this sudden thought and act out without consideration of its consequences.
Compulsivity is behavioral pattern where a person feels as if they have to act out in a particular fashion or their level of anxiety will escalate. As is the case in Obsessive Compuslvie Disorder (OCD), these individuals will often get a thought in their head (an obsession) that will increase their stress or anxiety. The compulsion is the behavior which is engaged in in order to release or relieve themselves from this emotion.
So is there such a thing as sex addiction? Maybe. Sex is part of the brain's natural reward system. It's not uncommon for many users of drugs to describe the high that they get as sexual in nature (case in point heroin users). Perhaps it would be better to think of it as a sexual compulsion, or an impulse control problem. Sex is often used, misused and abused given the number of relational needs that it can medicate, the rewarding/sensual payoff it provides, and the broad relational consequences it has. My guess is that we just need to be more careful in the language we are using, and less hasty with the Get Out Of Jail Free mentality that addiction language provides. When we start doing that, we will get a better handle on what the root causes of the behavior are better able to help those affected understand their situation.