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Jon E. Grant, JD, MD, MPH, Brian L. Odlaug, PhD, MPH, and Samuel R. Chamberlain, MD, PhD

Risky Behavior

Reclaiming your life from a behavioral addiction

At some point in our lives, we all engage in behaviors that are risky or unwise— behaviors that, deep down, we know are not rational. We might gamble on the lottery even though we know that, statistically, the odds are firmly against us; or we might impulsively buy some clothing or a gadget after getting our paycheck, never to remove it from its packaging. Why do we do this? In part we do it because these behaviors can be exciting and temporarily rewarding. They may allow us to forget about life’s problems for a short time. Often, we think we can control our behaviors: we allow ourselves the occasional indulgence because we think of it as just a “splurge” or reward for ourselves.

It is increasingly recognized, however, that certain behaviors, such as gambling and shopping, have the potential to become addictive. Just as substances such as alcohol and narcotics are rewarding and habit forming, so too are some behaviors. For people with behavioral addictions, a once relatively benign behavior can escalate, leading them to spend inordinate amounts of time preparing for or engaging in the habit, while neglecting other areas of life. These repetitive habits persist even though the person experiences negative consequences. Eventually many people find that they no longer have any conscious control over the behavior. One man told us, “I wish I could stop, but I just can’t. It’s like I have no control. How can that be? It’s so frustrating.”

As human beings, we pride ourselves on being able to control our behaviors. Whether in the arena of exercise, financial budgeting, or faithfulness to a partner, discipline is regarded as an enviable trait, and with greater discipline comes greater respect for ourselves and respect from others. Therefore, people who develop behavioral addictions can experience a great deal of emotional distress, including guilt and shame. John, a compulsive gambler, said, “I feel so ashamed because I’ve lost so much money, built up credit card debt, and have no savings left. How can I put my kids through college now?” Kate, who experiences irresistible urges to steal from local clothing stores, said, “I take things I don’t even need. Afterward I regret it, but I can’t take them back. I feel so worthless.” Over the years of treating people who have behavioral addictions, we have heard one comment repeatedly: “I run a business, manage a family, and control myself in so many ways. Why can’t I control this behavior?”

Behavioral addictions are frequently hidden from friends, family, and partners. Kate, who compulsively steals from shops, works as a lawyer and has a family: “To everyone else, I have a successful job and happy family— two kids, a loving husband, and a dog. I think people would be amazed to know that I steal. To be honest, I don’t understand why I do it.” Andrew, who was addicted to the Internet, described his behavior in this way: “My friends teased me that I wasn’t going out any more. Some of them just moved on and found other friends, forgetting me. Others asked what was wrong, but what could I tell them? ‘I’m addicted to the Internet’? It’s only when I got depressed because of my Internet addiction that they noticed and encouraged me to get help from my family doctor.”

When severe, behavioral addictions can significantly impair people’s ability to function, whether in personal relationships, work, or finances. Because of these profound consequences, ultimately individuals may not be able to hide the addiction, despite their best efforts to cover it up. John had built up huge debts, the family home was at risk of being foreclosed, and his wife eventually saw the threatening legal letters. Kate’s work had been suffering because of the amount of time she had been spending in stores. Every time she stole something, she risked catastrophic consequences. If discovered, she could get a criminal record, be forced to pay a fine, ruin her career, and suffer damage to her social and family relationships. Effectively, although Kate appeared fine, she was at the brink of losing everything. Things came to a climax when a store clerk caught Kate stealing something and called the police.

Jon E. Grant, JD, MD, MPH, Brian L. Odlaug, PhD, MPH, and Samuel R. Chamberlain, MD, PhD are the co-authors of "Why Can't I Stop?: Reclaiming Your Life from a Behavioral Addiction"


About the Author

Jon E. Grant, JD, MD, MPH, is a professor of psychiatry. Brian L. Odlaug, PhD, MPH, is an adjunct faculty in public mental health. Samuel R. Chamberlain, MD, PhD, is a clinical lecturer and psychiatrist.