Addiction (No Substances Required)

When most people hear the word addiction they immediately think of substance abuse — alcohol, illicit drugs, prescription drugs, cigarettes, etc. They typically don’t think about gambling, spending, video gaming, romancing, or being sexual. Yet it is just as possible to become addicted to a pleasurable behavior as to a pleasure-inducing substance. Furthermore, substance addictions and behavioral addictions (also called “process addictions”) are remarkably similar, evidenced by:

• Preoccupation to the point of obsession with sourcing, acquiring, and using a particular substance or behavior
• Loss of control over use (failed attempts to quit)
• Directly related negative life consequences, including relationship problems, trouble at work or in school, financial woes, loss of interest in previously enjoyable activities, social and/or emotional isolation, declining physical and emotional health, legal issues, and more.

Sadly, the general public and even many therapists tend to view behavioral addictions as less serious than substance addictions, even though behavioral addictions typically wreak the same types and degree of havoc as alcoholism and drug addiction.

Survival Turns to Escape

Much of the confusion around behavioral addictions stems from the fact that many addictive behaviors are—for most people, most of the time—healthy and maybe even life-affirming activities. For instance, eating, romancing, and being sexual contribute to survival of the individual and the species. In fact, these activities are so essential to life that our brains are pre-programmed to encourage them.

Activities like eating and being sexual trigger the release of dopamine into an area of the brain called the nucleus accumbens, also known as the “rewards center,” resulting in feelings of pleasure and contentment. This information is then transmitted to various other brain centers, most notably those in charge of memory, mood, and decision-making. Over time our brains learn that an easy way to feel better is to repeat the pleasurable experience (eating, romancing, having sex), thereby ensuring survival. This is intelligent design at its finest.

Unfortunately, people who struggle with underlying emotional and/or psychological issues sometimes learn to abuse the brain’s dopamine response as a means of coping with stress and masking emotional pain. Eventually, the pleasurable activity is engaged in not to feel better, but to feel less. In time it becomes the person’s go-to coping mechanism for just about everything, resulting in addiction. (Addictive substances trigger the same basic neurochemical response, and they get abused for the same escapist purpose.)

Lost in ‘the Bubble’

The link between substance and behavioral addictions is perhaps best understood by thinking about a drug addict who, cash in hand, has found a source for the drugs he so desperately wants. The addict leaves work early without asking permission, hops in the car, and speeds off to see his dealer. Isn’t this person “high” already? After all, his thinking is impaired (he’s making bad decisions), his heart is pounding, his palms are sweaty, and he feels compelled to purchase and use the drugs no matter the consequences. He may even be spending money that is needed for rent or to buy food for his family. And the closer he gets to using, the harder his heart pounds, the more clammy his hands get, and the more tunnel-visioned and misinformed his thinking becomes. So yes, indeed, this addict appears to be high, even though there are not, as yet, any drugs in his system. This is because his brain remembers the pleasure that drugs have given him in the past, resulting in an anticipatory dopamine rush, which is the same basic experience that he gets from actually using.

Simply put, addiction is all about manipulating the brain’s dopamine response, and this can occur with or without the assistance of addictive substances. Sex addiction in particular centers on this anticipatory high. In fact, sex addicts get as much (if not more) pleasure and emotional relief from the fantasy and pursuit of sex as they get from sex itself. They even have a name for this trancelike state of neurochemical excitement: the bubble.

When they’re in the bubble, sex addicts lose touch with reality for hours or even days at a time—high on the idea of sex—with little or no physical contact. In fact, most sex addicts delay orgasm for as long as possible, knowing that orgasm ends the high and throws them back into the real world, where they are faced once again with the stress and problems they’d rather forget. In this way we can see that for both substance addicts and behavioral addicts the fantasies and actions that lead up to actually using or acting out (the ritualized “process” of the addiction) are every bit as desirable (in some cases even more desirable) than the actual drug or behavior.