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Objectives
Define behavioral addictions
Examine some of the most common behavioral addictions
Explore similarities and differences between behavioral and chemical addictions
Discuss similarities and differences in treatment between chemical and behavioral addictions
What is an Addiction
A substance, person or activity
Outside of ones self
Used to escape from emotional or physical pain
Continued despite negative consequences
Paradigm Shift
Addiction serves a survival purpose.
Addiction represents the best way a person had to cope until now
The addiction can become the personâs best friend
Everyoneâs ability to deal with life on lifeâs terms differs
Patients can address the ways issues from the past are impacting them today
How does it start
Lack of early bonding (Trust/Mistrust)
Lack of confidence (Industry/Inferiority)
Lack of self-esteem (Identity or Intimacy)
Recreational or Prescribed Use
Mental Health Issues
Jellenik Curve
Recreational Use
Occasional Use for Relief
Increasing craving
Increased triggers (stimulus generalization)
Unable to discuss the problem
Efforts to control fail (increased time and energy)
Continued use despite negative consequences
Stop using see the original problems plus the addiction-created problems
Use again
Addiction Characteristics
Inability to consistently Abstain
Impairment in Behavioral control
Craving; increased âhungerâ for drugs or rewarding experiences;
Diminished recognition of significant problems with oneâs behaviors and interpersonal relationships
A dysfunctional Emotional response
http://www.asam.org/for-the-public/definition-of-addiction
Chemical Addictions
Chemical Addictions
Substances directly impact the brain and/or nervous system
Behavioral Addictions
Activities that impact the pleasure centers
Adrenaline rush
Dopamine rush
Endorphin rush
Oxytocin
Similarities Between Behavioral And Chemical Addictions
Cause chemical reactions in the brain
Are a tool to escape or avoid pain
Produce a tolerance
Have psychological withdrawal symptoms
Can have devastating biopsychosocial consequences
Differences Between Behavioral And Chemical Addictions
Abstinence is not possible or ideal for some behavioral addictions (i.e. sex, food, shopping, exercise)
Many treatment centers ignore the substitution of a behavioral addiction for a chemical addiction
Apply It
Think about behaviors that your patients engage in when they are deprived of their addiction of choice. What behavioral substitutions appear?
Behavioral Addictions
Food
Sex/Pornography
Gambling
Shopping
Exercise
Internet
Relationships
Chaos/Drama
Basic Behavioral Principles
When faced with two choices, the tendency is to choose the more rewarding option
To increase motivation for change the less rewarding choice must become more rewarding
The alternate behaviors need to be equally rewarding as the âaddiction.â
Assessment
When assessing a person for mental health issues, always ask about how they cope and apply a modified CAGE questionnaire
Have you ever felt you needed to Cut down?
Have people Annoyed you by criticizing your behavior?
Have you ever felt Guilty about your behavior?
Have you Eliminated or reduced important roles, tasks or relationships because of your behavior
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