Nowadays, we hear a lot about behavioral addiction-people will not only indulge in alcohol or other drugs, but also indulge in seemingly harmless activities such as sex, shopping, video games, gambling, eating, and exercise. But are they really addicted?
A core controversy in the field of addiction is whether the so-called “behavioral” addiction—addiction to activities such as eating, exercising, sex, playing video games, and gambling—is a real addiction. But over the years, the concept of addiction has changed, and experts have different understandings of addiction. Therefore, controversy may continue to some extent until a consensus is reached. However, since the last update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), we have learned a lot.
Although a strong movement of addiction professionals and public opinion supports the recognition of addiction to behaviors such as sex, shopping, playing video games, the Internet, eating, and exercising, the American Psychiatric Association (APA) has developed, written, and published diagnostics and The Statistical Manual (DSM) only includes gambling disorders in its latest version (DSM-5).
There are both supporters and opponents of including every behavioral addiction as a “real” addiction, but there are a few notable exceptions, such as the clinical psychologist and author of “Excessive Appetite” Jim Ofe Professor De, he has long advocated the recognition of a series of addictive behaviors, and they tend to focus on one behavior rather than all behaviors.
However, each of the major addictive behaviors mentioned here attempts to develop diagnostic criteria based on the experience of the affected person. These criteria are very similar to the existing criteria for alcohol and drug dependence and compulsive gambling.
Outside the fields of professional psychiatry and psychology, the media has accepted and accepted the concept of behavioral addiction. “Oprah” is the most successful and highest-rated talk show in the history of global television. It often discusses topics related to a series of addictions.
These topics include recognized addictions, such as illegal and prescription drug abuse, behavioral addictions, such as sex addiction and shopping addiction, and other activities that are not usually included in discussions about addiction, such as self-harm (usually in contact with marginal Type personality disorder) and plastic surgery. Describing these activities as addictive behaviors resonates with patients and audiences, and it is clear that these programs are related to contemporary issues.
The history of the concept of addiction is based on research on people addicted to alcohol and other drugs. Because alcohol and other drugs can physically change the chemicals in people’s brains, leading to tolerance and withdrawal cycles, making people want more and more drugs, the entire foundation of addiction theory is based on the concept of chemical dependence. The toxic effects of alcohol and other drugs on the brain and other parts of the body reinforce the concept of addiction as a disease-people who drink a lot of alcohol and take a lot of drugs for a long time often end up very sick.
But in fact, the addiction disease model focusing on the physiological effects of drugs was originally designed to reduce the moral judgments of addicts, portraying them as “sick” rather than “evil”. The entire medical community is moving towards a further understanding of the role of stress and mental health in all areas of health and wellness. As preventive medicine and patient empowerment are viewed by professionals and the public as legitimate solutions to health care problems, the disease model of addiction is becoming obsolete.
Therefore, if gambling is an addiction, why not provide some people with other activities that are characteristic of addictive behavior and disappointment? Mainly because there is no research driven by relevant funding to fully support the existence of other addictive behaviors. And the research that does exist is scattered in many disciplines and areas of interest.
Is there a risk of including other problem-free behaviors along with alcohol and drug dependence? Both sides of this debate have important arguments.
The case is
The development model of each addiction, the thought process involved, the reward cycle for maintaining the addictive behavior, the social and relationship consequences, and the recovery process have a lot in common in the addictive behavior.
If we recognize that the addiction process itself, rather than specific substances or behaviors, is the cause of the problems that addicts face, then many of the difficulties of the current classification and treatment system can be overcome.
For example, understand that this is not gambling itself That is to let the gambling addict lose everything, but a process of escaping from reality, allowing the therapist to face, accept and improve his life with him.
Similarly, understand that drug users, binge eaters, over-exercising or obsessive bargainers are using these behaviors to try to avoid their life stress and make things worse in the process, allowing the treatment to focus on solving it. This question is not just about the behavior itself.
The inclusive addiction model also allows us to fully prepare people to deal with the risk that they will not only relapse to previous addictive behaviors, but also may develop another addiction. This common problem is due to not learning effective coping skills to deal with life stress, and focusing on previous addictive behaviors, and developing the same addictive pattern as another behavior.
Therapies, such as the stages of change models and motivational interviews, have been successful in treating various addictions. Recognizing that the addictive process is the main driving force behind all addictive behaviors, whether they are for a substance or an activity, more people can get help in the comprehensive addiction service.
Some of these services already exist, and the inclusion of different addictions in group therapy is very beneficial to the treatment process because people get rid of specific behaviors, but instead recognize what it does for them and how to satisfy this in a healthier way The demand is great.
Another positive aspect of treating behavioral addiction as a real addiction is that it no longer emphasizes the inappropriate model of addiction disease, which has come to an end and no longer satisfies its original purpose.
be opposed to
An important argument against including a range of behaviors in the concept of addiction is that they may not be addictions. Although the pattern may be the same, addiction to substances may be a completely different process from compulsive behavior. As Dr. Christopher Fairburn said: “The fact that things are similar or have common attributes does not make them the same. Just focusing on these similarities…will distract the differences between these behaviors.”
Another argument against including non-material behaviors in addiction theory is that the physical consequences of alcohol and drug use are so severe that including less harmful activities will dilute the importance of “real” addiction and make them social It’s easier to be accepted. This dilutes the severity of alcohol and drug dependence, making these substances look as harmless as consuming too much in a shopping mall or indulging in chocolate cake.
In addition, some people think that including non-material activities as addiction means that the term is used so loosely that it can be applied to any behavior, and everyone may be considered addicted to something. Jim Orford quoted another psychologist Hans Eysenck as saying: “I like playing tennis and writing psychology books; does that mean I am addicted to tennis and book writing?”
The media continues to use the label of addiction to describe excessive behavior, and it is used in everyday language when people seek help for themselves and their loved ones’ excessive behavior.
Responding to criticisms of inclusive addiction methods:
Individual and specific aspects of each addictive behavior can be solved, and people can solve the psychological aspects of addiction, and can be combined with medical methods.
The comical argument that addiction can be applied to anything that anyone likes does not capture the point. It is not to enjoy an activity to make it addictive, but to over-participate in it so that other areas of life are affected. If Hans Eysenck plays too much tennis so that his health and relationships are affected, then he is definitely addicted to playing tennis. The same is true for his book writing.