Process Addictions: Non-Substance Use Disorders

We tend to joke about addiction. We say that we’re “addicted” to Sour Patch Kids or that we’re “addicted” to a new show we started binging on Netflix. But, in reality, if most of us really need or want to stop either of those things, the process is pretty easy. We enjoy these things, but we do not develop a psychological or physiological dependence on them. Is it possible, however, for binge watching, for instance, to become a real addiction? After all, until recently, addictions were relegated to strictly illicit substances, such as drugs and alcohol.

The short answer is yes, there is a possibility and a potential of developing addictions to entities other than drugs and alcohol. In fact, these entities are rarely illicit and are easily accessible to most of us because they are patterns of behavior that most of us practice on a regular basis. Processes such as eating (or not eating), roaming the internet, having sex, gambling and exercise can all be taken to an extreme, to the point that we do those things not because we want to but because we’ve developed a need to.

These behavioral addictions are formally called process addictions, which appropriately underscore how they differ starkly from substance addiction. Substance addiction deals strictly with the ingestion of substances whereas process addictions deal with the behavioral process and not the substance itself. Because process addictions have only been recognized as a type of condition in the last few decades, treatment options are not as abundant or as well researched as those for substance addictions. Part of understanding what kinds of treatments will be effective for different process addictions includes understanding where they differ and align with substance addictions.

Experts believe that process and drug addictions have a lot in common. Just as drugs can trigger a chemical and electrical response in our brains that creates a heightened euphoric sensation, so, too, can engaging in certain behaviors. Eating, sex and shopping, for example, can cause the same unusual spikes in chemical release and uptake that certain drugs can. And just as individuals can develop a tolerance to drugs over time, therefore needing more of the drug to get close to feeling the original high, so, too, can our bodies tolerate more and more opportunities to swipe that credit card or spend extra time online. The danger in this for process addictions is when things go so far as to cause harm to the individual exhibiting the behavior or even to others. A sex addict, for instance, might need to perform more risqué sex acts to feel any sort of gratification and, in the heat of the moment, could push their partner to do something that endangers them, as well. Moreover, just as former addicts experience withdrawal symptoms soon after stopping drugs (think Nicky Nichols from Orange is the New Black), someone who was addicted to gambling may actually feel both emotional and physical distress in the immediate time following their departure from the habit.

Another key similarity between the two types of addictions is that the same factors tend to predispose people to beginning them in the first place. Generally, though not always, in both cases, addictions begin as a way to cope with negative or overwhelming emotions. Process addictions are also more likely to develop if one already has a substance addiction, and research shows that for gambling and sex addictions, especially, substance abuse has a strong co-morbidity. Similarly, multiple process addictions can occur together. Again, sex and gambling often occur together, and some experts believe it has to do with their tendency to reinforce and substitute one addiction for another, depending on the individual. Issues such as psychiatric conditions, poor impulse control, risk-taking, childhood neglect or trauma, prior experience of physical or sexual abuse, poverty and other forms of social marginalization have also been linked to process (and substance) addictions.

Pinpointing the precise prevalence of process addictions has been difficult for researchers for various reasons. Such reasons include different cultural notions of what actually constitutes an addiction in different communities, the point at which a behavioral pattern becomes an addiction is inherently difficult to measure and define, data is less empirical and more qualitative or “impressionistic” and research bias tends to lead to overestimates of people with these addictions.

Goals of any sort of treatment therapy for addiction should be to decrease the frequency and intensity of relapses, lengthen periods of remission and help people perform optimally during those remission periods. Therapy for addiction should also try to assess the predisposing factors that led to the addiction as well as precipitating factors that have prolonged it, the patient’s current level of functioning with the addiction, how the addiction has affected his or her relationships with people and work, triggers, the patient’s individual treatment goals and other important elements.

If you think you or someone you know might have an addiction, treatment centers and resources such as The Refuge, The Ranch, Foundations Recovery Network, The Recovery Village and American Addiction Centers are often confidential sources for guidance and steps toward healing.


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