These days I work a lot with clients coming to psychotherapy with issues related to addiction.  These people are often struggling with dependence on alcohol, marijuana, pornography, sex, food and other habitual behaviors. They often feel stuck with these behaviors and may have made attempts to stop that failed in the past. Sometimes, these behaviors do not register as problems in their life.  Sometimes the problems these behaviors cause are glaringly apparent (a DUI, getting fired from work).

It seems to me that in my 15 plus years of doing psychotherapy, there is a greater number of clients now presenting with these conditions than ever before.  Perhaps there are various reasons for this.  Modern life has gotten particularly complicated and high pressured.  The economy for several years now has been a source of a great deal of stress for people struggling to just stay afloat.  And the access to the things that people may abuse has, especially through the prominence of the internet, gone (to use an internet term) viral.

I do not believe in one-size-fits-all explanations for what drives a person toward addiction. With each of my clients, we must do the hard work of inquiring into the meaning of these behaviors.  And then there is more hard work of together figuring out how to replace these habits with ones that will be truly more helpful and less self-injurious. The work is difficult; and all too often the addiction easy.  A central component to addiction is the ease with which it is available. Often that means just reaching for another glass of alcohol, taking another hit of pot, surfing the internet.

There can be some confusion as to what constitutes addiction versus compulsive behavior or for that matter just problematic behavior.  A client may wonder: Is it an addiction? A compulsion?  Often these distinctions fall away as the client and I search for the meaning of the behaviors.  More relevant in our work than finding the right diagnosis is the attempt to acquire a realistic prospective of the significance of these behaviors in a person's life and the impact they have on that life.  In general, we can say that in terms of addiction, a person will habitually indulge in this behavior in ways that take up a lot of his time, have some negative effect on the other areas of his life (for example on relationships or in the job setting), and are difficult to cease (often a person has made several attempts to do so).  These then tend to be some signs of an addiction.

And while each client and I must learn the meaning of his particular behavior, from my years of experience, I have come to identify certain key aspects of addictive behavior.  These key components tend to be present regardless of the substance being abused.  These components include the addictive behavior as a strategy for coping with something distressing in a person's life.  And the fact that inherent in these habits is the idea of instilling control and predictability in one's life.  In future blog entries, I'd like to expand on these key components and talk about the work of psychotherapy to deal with addiction and the underlying feelings that addiction is an attempt to cope with.