Signs of Trouble
Five Criteria for Addiction Assessment
by Steven Earll, MA, MS. LPC, LAC
Addictions and compulsions are destructive behaviors that an individual acquires as a method of coping with the pressures of life. Some addictions have genetic components and are passed down through biological families. Alcohol and drug addictions are examples of genetic conditions. Other addictions can be linked to survival reactions in response to family trauma. Sex addictions and eating disorders can have roots in emotional, physical, or sexual abuse. Addictions such as overwork, gambling, overspending, smoking, and compulsive exercise appear to be the result of bad habits. Most addictive behaviors are maladaptive responses to unresolved trauma.
Whatever the origins, all addictions and compulsions share the same criteria. The following outline describes addiction thought and behavior patterns that overpower a person’s life. These criteria can be used for understanding and evaluating an addiction or compulsive behavior.
One important note: if an individual doesn’t line up precisely with these criteria or if he or she only finds one or two that apply, this should not be taken as an absence of a problem. An individual may be engaged in risky or harmful behaviors that do not rise to the level of addictions. The absence of a clinical diagnosis of addiction does not mean a person is healthy. Some people may be on the road to addiction later in life. It is important that each person takes careful inventory of his thoughts, emotions, behaviors, and spiritual health and take appropriate corrective measures whenever necessary.
All addictions and compulsions involve fantasy. If an addiction or a compulsion does not divert a person’s mind from reality, it’s not worth doing. For the addicted person—or the person starting down addiction’s path—life’s stresses often feel overwhelming or unbearable. Fantasy is a method of survival that allows mental escape from pressures.
Fantasy creates excitement and anticipation, which, in turn, often triggers an addiction episode. James 1:13-15 is an excellent description of addiction.
When tempted, no one should say “God is tempting me.” For God cannot be tempted by evil, nor does he tempt anyone; but each one is tempted when, by his own evil desire (fantasy), he is dragged away and enticed. Then, after desire has conceived, it gives birth to sin; and sin, when it is full-grown, gives birth to death.
People are enticed by their own desires, or fantasies, which stimulate the need to act out the addictive behavior. When fantasy is nurtured, it takes on a life of its own. The fantasy about engaging in the addictive act and the emotional rewards resulting from the addiction behavior become a preoccupation. This preoccupation is so strong that many times it triggers physiological responses in the brain and body.
In other words, what people think about, their bodies treat as real. The addict begins to physically respond to the addiction when they fantasize about the physical act involved. A sex addict will experience excitement and arousal by thinking about a sexual encounter or anticipating looking at pornography. A drug addict can begin to feel the warmth and euphoria of intoxication by anticipating the drug use. Preoccupation about food can turn off the physical hunger response of an anorexic. The hardest part of recovery from an addiction is taming the mind and controlling the fantasy process. The power of fantasy is the enduring power of addiction.
When a person engages in an addiction behavior, his or her feelings are altered. The medication of emotions in this context refers to the temporary relief of stress and the creation of happier or euphoric feelings. At times, the behavior temporarily quiets the chaos of the mind. For a time life feels better.
The truth and danger of this is that addictive behaviors are more consistent that any relationship. When embraced, they result in euphoric feelings a majority of the time. This change is more reliable than any friend or any other relationship. It is this consistency that makes the addiction the strongest relationship in the addict’s life. The other edge of the addiction sword, however, is that addictions are progressive. What once provided that euphoric feeling will soon no longer provide it. The addict must seek out harder substances or experiences to regain the initial high. Thus the addict is drawn more and more into the addictive behavior with less and less to show for it.
False Sense of Control
One of the lies of an addiction is that it helps us control our lives. All lives have stress and, at times, life feels out of control for everybody. For the addict, addiction becomes one of the first and only behaviors that they turn to relieve the stress and regain control. Other alternatives are discounted as having little or no affect on their unique stress situations. A person who has trouble with anger will seek an episode to explode with rage rather than talk about situations that upset them. A sex addict prefers a session of Internet pornography to exercising to relieve stress. A person addicted to cigarettes will set up their day around stress-relieving smoke breaks. The stress relief creates a false sense that life is in control again and that the problems have been abated.
Another factor concerning the false sense of life control is that the addicted person will refuse to address the causes of the life stress, opting instead for the mood change of the addiction. The alcoholic who claims that their marriage is bad will drink and blame it on their spouse instead of facing marriage issues. For a person with money addictions, the stress of financial problems is often escaped by a spending spree rather than using their resources to relieve the debt. The addict's thought process persistently believes that no matter how bad a situation gets, the addictive behavior will be strong enough to counter any life stress.
The power of fantasy is the enduring power of addiction.
The reality of the situation is that addictions do not provide control of life pressures and are instead the primary cause of increased life stress and chaos. Addictions progressively affect all areas of an individual’s life, including their spiritual life, work, health, finances, decision-making, and family relationships. The degree to which any behavior negatively affects these areas indicates the depth a person is in trouble with that addiction. Over time, it is easy to see the downward spiral addictions create in a person’s life and how the hope of control is replaced by a progressively out-of-control lifestyle.
The power of any addiction includes the fact that the behavior is self-nurturing. Self-nurturing means that the addict can decide the timing of the action, the amount of substance or behavior, the mix of substance or behavior, and the amount of stress that is allowed to build before indulging. Self-nurturing actions are self-administered. The allure for the addict is that they control the nurturing.
The timing and anticipation of the addictive behavior is an important part of the process. The more time an addict waits, the more they experience the affects of delayed gratification and the more self-nurturing it feels. Timing issues also include creating the proper setting. An alcoholic may anticipate a social situation to create an excuse for intoxicated behavior that may be out of control. A person with an eating disorder may plan for time in the bathroom in order to vomit after eating. Sessions of Internet porn are often planned around time when the addict is alone or the family is asleep. A proper setting becomes part of the addict feeling nurtured.
The amounts of substances and behaviors can be manipulated for new levels of euphoria in addictions. If one dose of a drug is good, two will be better. If an hour of pornography is great, all night binges may produce more stress relief. If one sexual relationship is not enough, then several more may fulfill the addict. Seeking new highs through experimentation with the amount and mixture of substances or behaviors is a quest that only results in increased depravity. A Chinese proverb concerning alcoholism says that one drink is too many and ten thousand drinks are not enough.
When one addiction can no longer provide the needed escape, other addictions can be added to enhance the experience. Most addicts have one primary addiction and one or two secondary addictions. Drug and alcohol addictions are often combined with sex addictions. Anorexia and addiction to compulsive exercise are common. Engaging in multiple addictions can be a part of any given day. An example would be waking up in the morning, taking a few pills to get going, using nicotine to help with the energy during the day and drinking alcohol while looking at porn to relax at night.
Addicts often consciously and subconsciously let stress build to increase their experience of euphoria. When stress is allowed to build up to a fever pitch, the relief of engaging in addictive behavior is much more intense. A person with an eating disorder may not eat for days to enhance a planned eating binge. A workaholic may take on overwhelming workloads, resulting in sickness that allows them to escape professional and family responsibilities for a time. Creating a conflict at home justifies an intense drinking episode at the bar. The greater the level of stress, the greater the relief experienced by the preferred indulgence.
All addictions have a strong component of self-destruction. This appears to be contrary to the nurturing part of addiction. Addictions produce strong experiences of guilt, embarrassment, violation of personal values, and broken promises to self and others. This results in self-hatred and self-hatred creates a need to be punished. When an addict feels self-hate they will often indulge in the same addictive actions to quiet the shame. This results in more self-destructive behavior and increased shame.
Feelings of shame serve to trigger the cycle of addictive behavior. After a period of time indulging in self-hate, the addicted person will want to feel good. The need to escape the hate will lead to fantasy, which begins anew the addictive cycle.
Addictions are extremely serious and many are fatal. All addictions lead to the spiritual, emotional, physical, and social destruction of the addict. There is help and resource material available for those who are affected by addictions. For assistance please contact the Focus on the Family counseling department at (719) 531-3400 x7700 between 9:00 and 4:30 p.m. MST. Trained professional counselors will speak with you or help identify a counselor in your area to provide continuing assistance.
Steve Earll is a Licensed Professional Counselor and a Licensed Addictions Counselor in private practice specializing in family trauma, addictions, co-dependency, and recovery issues in Colorado Springs, Colorado. Steve has conducted training with therapists, educators, and churches concerning issues of addictions and family trauma in the United States, Canada, Europe, and the Middle East.