What is Addiction?
“Addiction”, “addictive” and “addicted” are very commonly used terms these days, not only in relation to familiar traps such as alcohol, cigarettes, gambling, heroin, cocaine etc, but also when talking about the newer challenges posed by ever-present availability of social media, pornography, dating apps, gaming, online shopping, etc, etc. Sometimes these terms are used too carelessly and flippantly in everyday life, as if everyone is addicted to everything – we all have some bad habits, but addiction means something over and above this. And I think it is important to know more clearly just what it is (and isn’t), for a number of reasons:
- It helps us to take the appropriate individual and social response to addiction where it exists, neither underestimating its prevalence, nor overreacting unnecessarily
- It gives people, especially younger people, a better chance of avoiding the many potential addictive pitfalls, by learning to identify addictive risk at an early stage of the process
- It helps us to understand whether the category of addiction or addictive behaviour really can be applied in the new world of instant communication technologies
So, clarity in defining what we mean when we use these terms is important, and of more than just academic and professional interest. But obviously definitions are mainly going to come from academics (lecturers and researchers) and professionals (psychologists, psychiatrists, psychotherapists, counsellors), so let’s take a look at what some of them say.
The American Society of Addiction Medicine gives the following as their “Short Definition of Addiction”:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
Some would see the emphasis on “disease” and “brain” here as unwelcome, but then we are talking about the American Society of Addiction Medicine. That aside, I think there are a lot of useful concepts packed in here: the primary nature of addictive behaviour (it’s not just a symptom of another problem); addiction as a problem of reward and motivation gone wrong; the idea that addiction has biological, psychological, social and spiritual aspects; the experience of craving as an aspect of the addicted state; difficulty recognising problems with one’s behaviour (“denial”); cycles of relapse; and the progressive nature of addiction.
Mark Griffiths, a psychologist at Nottingham Trent University who specialises in research on behavioural (as distinct from substance) addictions, offers a simpler set of “Operational Criteria of Addiction”:
- Salience (Preoccupation)
- Mood Modification
- Tolerance
- Withdrawal
- (Inner) Conflict
- Relapse
This summary adds an emphasis on: the mental aspect of addiction (the obsession/preoccupation of the addict with the object of their addiction); the centrality of intense positive mood change in all addictive behaviours (the reward which is being sought); the inevitable tolerance which leads to the progression mentioned above; the pain of withdrawal which sends the addict back to addiction; the conflicted state of the addict (they both love and hate the addictive object).
Looking at all of the above, it’s interesting to note both the commonalities with bad habits (relapse, some denial, motivational conflict, some preoccupation) and the differences (habits don’t lead to much tolerance and so aren’t very progressive; don’t involve intense mood change or craving; have relatively low levels of both preoccupation/obsession and denial/defensiveness).
Addiction could possibly be summed up as “Compulsive Self-Rewarding Behaviour”, but despite the fact that it has obsessive and compulsive elements it is distinct from OCD (which could possibly be summed up as “Compulsive Self-Protecting Behaviour”, as it is driven by the avoidance of perceived threats rather than the pursuit of perceived rewards).
Another way of looking at addiction is to describe it as a particularly serious and damaging failure in self-regulation, due to more balanced development being disrupted and sidetracked by dysfunctional learning/conditioning experiences with supernormal stimuli. What is a supernormal stimulus? Evolutionary Psychology points out that psychological mechanisms which evolved to motivate us to pursue essential life goals (feeding ourselves, mating, etc) can be “hijacked” by intensified, artificially-enhanced stimuli which elicit a particularly highly motivating, hard to resist response e.g. junk foods, pornographic images, cocaine, social media etc.
Putting some of these ideas together, I like to think of addiction as:
A progressively tolerated, progressively damaging dependency on, and preoccupation with, the intensely mood-altering, but only superficially satisfying, emotional rewards provided by
certain artificially-enhanced activities (and their associated rituals), which require minimal personal investment (e.g. using porn, gambling, eating sweet foods, etc),
leading to a vicious cycle of compulsive behaviours which the addicted person sometimes tries to control, with limited success, in response to damage in multiple domains of their lives but otherwise resists acknowledging by using various cognitive-emotional distortions/defences.
Addiction is complex (“cunning, baffling and powerful”, as they say in AA) – all the more reason for us to make serious efforts to understand it clearly and talk about it clearly.