When is it addiction?

With the recent focus on Tiger Woods and the concept of sexual addiction, some are wondering about where addiction comes from and how to assess for it.

A friend asked me, “Is it because he grew up with a controlling father?”

We still don’t have a clear answer to whether addiction stems from nature or nurture, genetics or environment, but research provides some clues.

A new study from Washington University School of Medicine finds that both alcohol and marijuana dependence symptoms can be traced to some of the same genetic influences. Many studies support the idea of a common physiological mechanism underlying all addictions.

Robert Dilts and other pioneers in the field of neuro-linguistic programming see addiction as an example of some type of multilevel program that has taken over the brain. Triggers at the environmental, behavioral, cognitive and spiritual level all influence this program.

Addicts have become enslaved to a particular substance or behavior, one that usually represents a poor substitute for what is really desired.

For example, a workaholic may use excessive focus on the job to make up for feeling inadequate in other areas of life, such as marriage or parenting. An adolescent may use marijuana to feel less social anxiety and be able to fit into a particular peer group.

Another common issue involves medicating painful feelings; Claudia Black, Ph.D., a pioneer in the field of addiction and recovery, notes that “recovery is the ability to tolerate your feelings.”

How does one recognize addiction when denial is such a hallmark of the disease? It often takes family or friends to encourage a loved one to look at excessive use or behavior.

Common elements characterizing addiction include feeling powerless over it, a resulting inability to manage life responsibilities, failed promises, preoccupation with it to the point where it is the primary focus of thought or action, and feelings of personal shame and self-loathing.

Some experts believe that all addictions represent a spiritual void or lack of life meaning. Certainly there is a deep, inner pain and sense of powerlessness present for those who are addicted, if they are honest.

In fact, admitting this is the first step of Alcoholics Anonymous (AA) “Twelve Steps,”which outlines one way to achieve and maintain sobriety.

The person who is addicted has to come to believe that s/he has a problem before any steps can be taken. AA describes it as “reaching bottom,” or that point at which one cannot continue in the unhealthy lifestyle as it has become, finally, too costly.

With more and more addictions emerging, including Internet pornography, gaming and even use of MySpace or Facebook, mental health researchers are trying to understand how people change unhealthy behavior.

Psychologists Carol DiClemmente, Ph.D. and James Prochaska, Ph.D. have identified five stages of change. These stages are precontemplation, contemplation, preparation, action and maintenance. Precontemplation is the stage before an individual is aware of negative behavior. People are most likely to respond to feedback and education in the contemplation stage but need to advance to the preparation stage to be actually committed to change and seek a way of doing it.

Those in the action and maintenance stage are working actively with the help of social reinforcements, in the change mode.

The American Psychological Association defines addiction as “a condition in which the body must have a drug to avoid physical and psychological withdrawal symptoms.”

The individual must have more and more to achieve the same effect. Many behaviors, even those defined in healthy lifestyles, such as exercise, can achieve lethal proportions.

Addiction is on the rise. One thing we professionals do know is that the potential for healing is more profound when you don’t ry to go it alone.

Deborah Barber, Ph.D., is a clinical psychologist in Westlake Village. Call (818) 512-7923 or go to www.DrDeborahBarber.com for more information.