Almost everyone understands “addiction” when it comes to substances like alcohol, nicotine, illicit drugs and prescription medications.
But fewer are aware that healthy — even life-affirming behaviors — can grow compulsive too, developing into behavioral addictions (also known as “process addictions”).
Eating and sex, two of the most commonly diagnosed behavioral addictions, are absolutely necessary to human existence, as they contribute to survival of both the individual and the species. In fact, these activities are so inherently necessary that our brains are pre-programmed to experience them as pleasurable (as a way to ensure that we at least occasionally engage in them).
Essentially, pleasurable behaviors cause the release of pleasure-related neurotransmitters — dopamine, oxytocin, serotonin, and a few others (but mostly dopamine) — into an area of the brain called the nucleus accumbens, more colloquially known as the “pleasure center” or the “rewards center.” The pleasure center then communicates with other parts of the brain, most notably centers controlling mood, memory, and decision-making, letting those brain centers know how much it enjoyed eating or being sexual (or whatever). Later, we use this information in decision-making.
Unfortunately, the brain’s pleasure center can be hijacked. It is probably not a surprise to learn that this hijack process occurs when addictive substances are ingested.
Typically, addictive substances flood the brain with two to ten times more dopamine than normal pleasure-inducing behaviors (eating a healthy meal, spending time with a loved one, helping a friend, etc.) Notably, the exact same exaggerated pleasure response occurs when we engage in highly refined, incredibly intense versions of “normal” pleasure-inducing behaviors (eating chocolate cake as opposed to salad, playing for money instead of “for fun,” having sex with lots of people we’re not married to instead of our spouse, etc.)
Of course, an occasional excessive jolt of dopamine is not necessarily a bad thing. For instance, many people occasionally drink alcohol, sometimes even to excess, without becoming alcoholic. Similarly, many people occasionally eat junk food, gamble, and/or act out sexually without becoming addicted.
Why do people become addicted?
The issue of addiction arises when people begin to use these behaviors compulsively and to excess as a way to cope with life stressors and the pain of underlying psychological conditions like depression, anxiety, low self-esteem, unresolved trauma, etc. In other words, some people learn to use (abuse) these behaviors to escape from life rather than to enjoy it. This is the exact same reason alcoholics drink and drug addicts use.
Essentially, the unconscious goal of all addicts is to gain a sense of control over challenging emotional states (including things as seemingly benign as boredom) by doing something that temporarily masks their discomfort. Over time, this can become the default response to anything and everything, engaged in over and over regardless of the negative life consequences that may ensue (excessive weight gain from an eating disorder, financial woes from gambling, ruined relationships from sex addiction, etc.)
When a repetitive pattern of pleasurable behavior is engaged in for this purpose — self-soothing and emotional regulation — and takes over a person’s life, that individual has developed a process addiction.
Sadly, many in our culture still view behavioral addictions as moral failings rather than chronic, progressive, and treatable illnesses. Food addicts are labeled “fat and lazy,” sex addicts are labeled “perverts,” etc., much as society used to call alcoholics “bums” and drug addicts “degenerate fiends.” This occurs primarily because our culture, as a whole, has a limited understanding of behavioral addictions, typically viewing them as less serious than “real addictions” (i.e., substance addictions). However, process addictions are every bit as real and destructive as chemical addictions, with out-of-control compulsive behaviors wreaking the same types and degree of havoc on families, careers, and lives as unrestrained substance abuse.
The good news is there are now several excellent treatment facilities dealing with addiction of all types — substance use disorders and behavioral addictions alike.