A bad day at work or stress in a relationship can lead to people engaging in self-soothing behaviors such as eating comfort food or participating in “retail therapy” as a way of redirecting their mind onto something more enjoyable. However, there is a line when “escaping” into pleasurable behavior can go too far, especially if those behaviors cause additional problems for yourself or become addictive in nature. When we think of addiction, we think of drug and alcohol abuse that has gotten out of control. In recent years, behavioral addictions such as gambling, sex, work, and food have gained acceptance by society as problematic compulsions as well. How substance and behavioral addictions relate to each other is known as addiction interaction. So you may be asking how do different addictions emerge with someone who may have addictive tendencies?
The concept of addiction interaction occurs when different addictions are used to replace, fuse, or mask each other to either maintain pleasurable feelings (i.e. “this feels good”), to numb or escape emotions (i.e. “I don’t feel as depressed when I can go online and look at porn”) or to minimize one’s primary addiction by focusing on another compulsion that may be less shameful or costly (i.e. “excessive shopping is better than using illicit drugs”). It is important to note that these processes usually occur outside a person’s conscious awareness, but because the pleasure-center in the brain remains stimulated (through high dopamine production), a person is more vulnerable to returning to the original addiction. For example, if you were originally addicted to pain medication and have maintained abstinence from this substance, but still use another similar substance such as alcohol, your return to abusing pain medication is more likely. This is not because you do not have the “willpower” to stay away from the pain medication, but because all drugs and other addictions raise dopamine levels in the pleasure center of the brain, thus keeping the addictive disease active. This same principle holds true outside substance-related addictions to other types of behaviors that have a euphoric effect. Simply put, a person engages in an addictive behavior (substance abuse or otherwise) to either feel “good” or to feel “less bad” which therefore makes any behavior that produces pleasure, or is expected to produce pleasure a potential problem.
Different addictions can occur when someone with a substance use disorder begins to engage in other “pleasurable” behaviors such as overeating, sexually acting out, or even over-spending money. A person may find binge-eating sweets pleasurable after a hard day or engaging in mind-numbing cruising of the Internet to get their mind off of how anxious they feel about doing a speech at work the next day. Both examples serve as external coping skills to help a person either “feel good” or “feel less bad” respectively, but also keeps the addictive process active in the brain due to the excessive pleasure derived from engaging in these behaviors compared to other people who may not be addicted. This idea is also comparable to the Whack-A-Mole concept; when one addictive behavior is under control, another one pops up. Below are some specific examples of ways different behavioral addictions pop up once a person’s pleasurable behavior crosses the line into addiction:
- Withdrawal mediation- to cope with the feelings of withdrawal, usually the psychological effects such as depression, emotional over-reactivity, anxiety, and even insomnia. A person may escape these unpleasant feelings through things like working excessively or numbing out playing video games in a compulsive way to help fix these symptoms
- Replacement- Instead of sexually acting out with prostitutes or escorts, you find yourself compulsively watching porn or masturbating
- Alternating cycles- You may be overeating during the winter, but when the summer season rolls around, your compulsive energy switches from a food addiction to excessive exercising
- Masking- This is when you present one addictive behavior outwardly, while keeping secret another addictive behavior. For example, you may be a recovering gambler and actively working on it, but secretly, you are also engaging in compulsive extra-marital affairs behind your partner’s back
- Ritualizing- Engaging in one addictive behavior as a precursor for another. For example, with the end-goal of hooking up for sex, a person may participate in cruising or seductive behavior with different people at clubs with a deliberate intention of getting them to go home with you
- Fusing- Similar to ritualizing which tends to be linear, fusing is when either one addictive behavior merges into another or more than one addictive behavior is being acted out at the same time. Watching porn is often fused with compulsive masturbation
To see what, if any, patterns of addiction interaction that you may be experiencing, consider doing the following exercise. Either find a long sheet of paper 11 X 17 or tape two 8 X 10 sheets together horizontally. At the left side of the paper and across the entire length, draw a timeline of your life up to your current age. You can also break your life down by five-year multiples or even decades. Leave ample room for writing in between each age range. Depending on the significant events that occurred within a particular age-range or decade, they do not have to be equidistant like shown below.
Viewed porn and masturbated ages 18-current
Smoked pot ages 14-22
compulsive gambling ages 31-33
Age Age Age Age
0-10 11-20 21-30 31-40
Parents Divorced Got married
(Age 7) (Age 27)
Underneath the line, write significant events (positive and negative) that you remember in that age bracket. For example, you might record that your parents got divorced when you were seven years old. Continue to identify the life events and ages throughout your entire lifespan. Above the line, write a range of each addictive behavior you may have or had. Mark each addiction with a different color and include overlapping age ranges if applicable. For example, in the above diagram, this person smoked pot from ages 14-22. He or she moved onto porn at age 18. Therefore, the person was acting out with pot and porn at the same time from ages 18-22, when he or she stopped smoking pot. When the exercise is complete, you should be able to see a progression of your life events (across the bottom) along with how any of your addictions “interacted” with each other (across the top in different colors). Be sure to note the approximate ages you were when different addictions occurred and then stopped.
As you are becoming more aware of the concept of addiction interaction, you may be concerned that you have many “addictive diseases.” The truth is that if someone has the disease of addiction, it is only one disease, but could show itself in different ways. It is important to know that having more than one addiction is very common and to not be too hard on yourself. If your addictive disease were a river and barriers or islands were in the middle of the stream, the water would travel around them, just like different addictions could evolve after having arrested one of them.
The goal here is to be aware of how different addictions can pop up at different times and not to judge or feel bad about yourself for it, but to apply your same recovery coping skills toward each one in a supportive, loving way. For additional help in identifying addiction interaction and applying the needed skills to maintain your sobriety, please call us at The Center for Growth and schedule an appointment at 215-922-LOVE or go to our website www.therapyinphiladelphia.com/.