Information

Is there a name for sudden addiction relieving clarity?

Is there a name for sudden addiction relieving clarity?

I struggled for years to quit smoking, then after many failed attempts I stopped without any difficulty. I've also experienced this on other things, like when I'll want to do something but I lack the discipline to do it, then eventually I'll have a surge of energy and willpower that will make it easy for me to get anything done.

What is the psychology behind this yo-yo surge of willpower?
How can I encourage my mind and body to bring on that heightened willpower?


Forex Psychology – Trading Can Be Addictive

‘Addict’ is a dirty word associated with the perceived down and outs of society, those who sleep on a park bench or live from one needle to another. But addiction invades slowly and surreptitiously and can hit anyone at anytime, although some are more susceptible than others. Genetic components definitely can and do play a role. Research has shown that the brains of addicts metabolize and process their drug quite differently from non-addicts. There is reason to believe that one part of the brain in particular is involved and that when it has been activated, the addiction takes over and stimulates uncontrollable behaviors.

Trading involves intense exercise of the brain and the will. It constitutes constant analysis and problem solving as performance-based skills become increasingly fine-tuned. Serious players of chess, poker and successful athletes develop and grow in similar ways.

However, trading can become an instrument for destroying mind, soul, body and lives. For trading can become an addictive activity. Whereas an addiction to alcohol and other drugs are substance addictions, an addiction to trading is a process addiction and thus much more difficult to spot and overcome. There is a great deal of research in this area that has yet to be done but consider the following:


Detachment: A Strategy for Friends and Family of Adult Addicts

For every adult who struggles with addiction, there are many affected by its destruction. Family, co-workers, and friends are among those who become witnesses to the downward spiral of self-destructive behavior. Attempts to fix a friend or loved one experiencing addiction become increasingly frustrating as the chaos becomes a part of daily life.

When you are affected by someone else&rsquos drinking or drug use, it is important to remember that even though you cannot prevent what&rsquos happening to them, you can regain your sanity by practicing detachment.

What is detachment?

Detachment is when you let other people experience their consequences instead of taking responsibility for them. This is a key component of the recovery process for family and friends of addicts. Redirecting focus away from an addict&rsquos negative behaviors can restore the balance of the relationship dynamics, as well as re-start self-care.

Of course, detachment doesn&rsquot mean that you stop caring. The popular phrase is &ldquoto detach with love&rdquo promotes loving the person, even when you don&rsquot approve of the behavior. Detaching means that you lovingly let go of solving the problems associated with the addiction.

When a person experiencing addiction misses work, neglects his or her responsibilities, or does something like crashing the car, let them handle it. This invites the addict to take responsibility for his or her own mistakes and take control of his or her own life.

The central premise of detachment is letting go of trying to fix the addict&rsquos life. This becomes especially difficult when the alcoholic chooses to do nothing because that refusal often triggers loved ones to rescue them.

However, by solving problems for the addict, you are preventing him or her from experiencing the pain associated with the addiction. Such pain is necessary in order for an addict to choose sobriety.

Family and friends of addicts often fear that the addict will end up incarcerated or dead. This fear is not unfounded sadly, many addicts continue using despite the consequences to their health and well-being. Therefore, that fear leads you back to rescuing them. However, rescuing addicts trigger a cycle of control that depletes family and friends to the point of emotional and physical exhaustion.

In Al-Anon, a 12-step program for friends and families of alcoholics, there is an important saying to help remind us of those necessary boundaries in relationships with addicts: &ldquoYou didn&rsquot cause it, you can&rsquot control it, and you can&rsquot cure it.&rdquo This phrase is helpful to consider in its parts:

You Didn&rsquot Cause It

Regardless of why the addiction started, you are not responsible for the behavior of a loved one experiencing addiction. You are only responsible for your own behaviors and your own actions.

You Can&rsquot Control It

Once a brain becomes dependent on a substance, rational decision-making is significantly impaired. This explains why an addict&rsquos behavior is no longer rational: they cannot see the impact that using has on their own behavior.

You Can&rsquot Cure It

An addict&rsquos brain gets hijacked by the dependency, which impacts his or her ability to think and make sound decisions. These physiological changes make it impossible for the addict to see what&rsquos happening to them.

To a non-addict, it may look like the addict can stop using. However, those who have never experienced addiction can&rsquot understand the physical allergy that creates the addictive response. This lack of control is the hallmark of addiction.

The Affects on the Family

Over time, living with active addiction creates anxiety, depression, and chronic stress for those closest to an addict. Many family members suffer in silence, while the addict doesn&rsquot see a problem. Children in particular act out and may become depressed or anxious.

The shame associated with addict&rsquos behavior prevents family members and friends from seeking help. As family members of addicts, you may isolate socially because it&rsquos embarrassing to witness the outbursts. You may stop talking to family and friends because you fear being judged.

Practicing good self-care becomes essential for restoring emotional and physical health of entire in the family. Dealing with active addiction creates a pattern of self-neglect that needs healing. Redirecting the focus back on what you need makes detachment possible because your energy is no longer spent solely on the addict.

How to Start Practicing Detachment

Detachment works best when you can detach with love. This means letting go of the anger and finding alternatives ways to handle the stress of living with an addict. Here are some beliefs that need to be addressed in order to detach:

  • Avoid making assumptions &mdash if you stop helping, something bad will not necessarily happen.
  • Challenge the belief that you have all the answers.
  • You are not responsible for an adult addict&rsquos problems.
  • It&rsquos okay for you to get your own support system.
  • Self-care isn&rsquot selfish, regardless of other well-meaning people say.

Detachment can transform the entire family dynamic. Practicing these behaviors will indirectly benefit the addict because he gets an opportunity to face the truth about his own behavior. Detaching also restores the family&rsquos equilibrium since the attention is no longer focused solely on the addict.

  • Not make excuses for an addict&rsquos behavior
  • Stop handling an addict&rsquos problems
  • Avoid becoming a passenger while he or she is intoxicated
  • Leave a situation before an addict becomes abusive
  • Stop responding to an addict&rsquos attempts to blame and
  • Accept that you are powerless over the addict&rsquos behavior.

Simple Detaching Behaviors That Work

  • When confronted with verbal attacks, silence works. If you need to, leave the room.
  • Recognize that rescuing doesn&rsquot help the addict long-term.
  • Take care of YOURSELF instead of trying to fix them.
  • Refrain from giving advice or preventing their use.
  • Keep children safe by minimizing their exposure.

Finding Additional Support

When considering options, recovery may include inpatient or outpatient treatment, individual and family counseling, and 12-step programs like Alcoholics Anonymous and Al-Anon.

Families often seek help before the addict does because watching the addict self-destruct becomes too painful. In recovery, the family learns not to force treatment but instead give the addict the dignity to decide on his own. Hiring a professional interventionist provides a more structured approach when the addict is out of control.

In particular, consider Al-Anon , a free support group for families and friends of those who are struggling with addiction. They also have groups for children affected by the disease. If you are not comfortable in groups, try some individual or family counseling for a more private place to heal.

Detaching is not easy but it does preserve the relationship without participating in the addict&rsquos disease. It separates the person from the addiction. Keep in mind that any addict has a disease much like mental illness. The addict cannot control their behavior, though they are responsible for their choices. Starting the process of growth and recovery is a delicate balance of loving the addict without attempting to rescue them.

It is very important that friends and family of addicts focus on taking care of themselves. To engage in self-care is difficult and takes practice but ultimately, there is no lasting relief without it.


Actions Speak Louder Than Words

Effective communication in the workplace doesn&rsquot have to be challenging, but it does have to be intentional. Knowledge can only take us so far, but once again, knowing something is very different than putting it into action.

Just like riding a bike, the more often you do it, the easier it becomes. Master communicators are phenomenal listeners, which allows them to be effective communicators in the workplace and in life. If you genuinely want to own your communication, you must implement this information today and learn how to improve your listening skills.

Choose your words carefully, listen intently, and most of all, be present in the moment&mdashbecause that&rsquos what master communicators do, and you can do it, too!


Compulsive Sexual Behavior Is Now Recognized as a Disorder, But It isn’t the Same as Sex Addiction

Though the concept of sex addiction has been a subject of debate for some time, there actually hasn't been an official diagnosis that addresses problematic sexual behavior—until now.

Last month, the World Health Organization (WHO) released the proposal for the 11th edition of the International Classification of Diseases (ICD-11), the first revision of the global standard diagnostic catalogue since 1990. And among the proposed changes is the addition of a mental health condition called compulsive sexual behavior disorder (CSBD), which is a pretty big milestone in the mental health community.

“This is the first time internationally that there is a category for dysregulated or problematic sexual behavior,” Shane W. Kraus, Ph.D., director of the Behavioral Addictions Clinic at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass., and assistant professor of psychiatry at the University of Massachusetts Medical School, who was part of the WHO work group that developed the diagnostic criteria for CSBD, tells SELF.

CSBD is characterized by “a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour,” according to its diagnostic description in the ICD-11 this can include both the act of sex and sexual fantasies.

The umbrella term “impulse control disorder” includes a variety of psychiatric disorders “whose essential features are the failure to resist an impulse to perform an act that is harmful to the individual or to others,” according to the ICD. Individuals typically experience an increased sense of tension before the act, but then pleasure or gratification when they do the act, it goes on to explain.

According to the ICD, the hallmark symptoms of CSBD are “repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it.”

For example, someone with CSBD might be over and over again engaging in sexual behavior that they full well know is damaging their relationship with the person they love, like putting their impulse to have sex over their partner’s desires and other aspects of their relationship, or having sex with someone who is not their partner (assuming they’re in a monogamous relationship) in order to satisfy those strong and frequent urges, or engaging in this behavior to the detriment of their job or other responsibilities.

While the official diagnosis may be new, for many mental health professionals, the condition is something they see and discuss often. “A lot of the therapeutic community has been talking about this issue and working with patients seeking help for these kind of sexual problems long before it was canonized in the ICD-11,” Rory Reid, Ph.D., LCSW, assistant professor and research psychologist in the Department of Psychiatry and Biobehavioral Sciences at UCLA, tells SELF.

Reid compares the lag between clinical evidence of a problem and an official diagnosis to the trajectory of PTSD: The disorder was recognized by the APA in the DSM in 1980 after a wave of veterans sought professional help for their similar experiences. “We had all these military personnel coming back from the Vietnam War having these symptoms—flashbacks, anxiety—and they were going in to therapists and psychiatrists to talk about them,” he says. “So therapists started working with it long before it was canonized as a disease or a disorder, and then the scientific community caught up and said, ‘Yeah we're seeing this, too.’”

Having a lot of sex or sexual desire doesn’t mean you have a condition, similarly to, for instance, how not everyone who drinks what some might consider a lot has alcoholism. “[Their behavior] might cause distress or it might be an issue for them, but it doesn't mean they have a mental health problem,” Kraus explains.

The ICD criteria also cautions against conflating violating social or cultural norms with having a clinical condition. It explicitly states that “distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours” does not factor into a CSBD diagnosis. For instance, being into kink, having multiple sexual partners, or frequenting sex parties may not be everyone’s cup of tea but it doesn’t qualify you as having CSBD. “Compulsive sexual behavior, when properly diagnosed, is not in any way related to who or what it is that turns a person on,” certified sex addiction therapist (CSAT) Robert Weiss, author of Sex Addiction 101, host of the podcast Sex, Love, and Addiction 101, and CEO of Seeking Integrity, tells SELF.

“People have sexual behaviors that vary across people and cultures and groups, and we want to make sure we're not overpathologizing people based on specific values,” Kraus explains. The CSBD diagnostic criteria are based on science rather than conjecture, and “very specifically take morality and personal judgement out of the equation,” Weiss says.

In fact, the fear of overpathologizing sexual behavior based on what we view as normal, proper, moral, or socially acceptable is actually one of the controversies that led the American Psychiatric Association (APA) to reject the proposed addition of “hypersexual disorder” to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) back in 2013, Reid points out.

The APA objected that the diagnostic criteria for hypersexual disorder did not clearly differentiate between “normal range high levels of sexual desire and activity” and “pathological levels of sexual desire and activity,” according to a paper that Reid co-authored in 2014. This lack of clarity created a potential for “false positives,” the APA argued, “erroneously diagnosing an individual with a mental disorder that is a normal variant of human behavior.”

WHO’s addition of CSBD has stirred up this existing controversy on the subject of how to define and diagnose disorders related to sexual behavior. “There was never any dispute that healthcare professionals are seeing [the issue of CSBD] all over,” psychologist Eli Coleman, Ph.D., director of the Program in Human Sexuality at the University of Minnesota Medical School and founding editor of the International Journal of Sexual Health, tells SELF. “It’s just been a matter of debate about what we call it.”

The specific language that the medical community (and society in general) uses for a particular condition matters it shapes our conception of the condition, and in turn, determines how people dealing with those issues are perceived and the treatment they receive. In the case of psychiatric and behavioral disorders, the name experts settle on and the category they file it under (addiction, impulse control disorder, obsessive compulsive disorder) refers to the underlying brain mechanism, or how that particular disorder is thought to be working in the brain. That then tells us how to approach treatment and what treatments are most likely to be effective, Reid explains.

In regards to CSBD, the largest point of contention is whether or not the disorder should be categorized as an addiction. “There is ongoing scientific debate on whether or not the compulsive sexual behavior disorder constitutes the manifestation of a behavioral addiction,” WHO spokesperson Christian Lindmeier tells SELF. “WHO does not use the term sex addiction because we are not taking a position about whether it is physiologically an addiction or not.”

But unlike the phrase compulsive sexual behavior disorder, most people are familiar with the term sex addiction. It’s also long been used by the mental health professionals that counsel people with these issues.


Physical Effects of Addiction

While many of the primary effects of addiction occur in the brain, the rest of the body can suffer as well. Substance abuse weakens the immune system and leaves the body more vulnerable to various diseases and infections. Drug use—especially through needles—increases an individual’s chance of contracting HIV, hepatitis, or other infectious diseases. Other physical effects of addiction include abdominal pain, digestive issues, trouble sleeping, or even seizures and other forms of brain damage. Addictive substances can impact every part of the body even beyond the following common issues.

Kidney Damage

Drugs can harm the kidneys both directly and indirectly. Many symptoms of drug use—such as dehydration, muscle breakdown, and increased body temperature—can contribute to kidney damage. This damage worsens as these symptoms persist over time. Unfortunately, it is relatively common for long-term drug users to experience kidney failure or other forms of kidney damage. The same is true for individuals who regularly consume a large amount of alcohol. Heavy drinking increases an individual’s risk of chronic kidney disease.

Liver Failure

Liver damage is a well-known consequence of heavy drinking. However, both alcohol and drug addiction can lead to serious complications and even liver failure. The liver is responsible for clearing toxins from the bloodstream. When an individual partakes in the use of drugs or alcohol on a regular basis, they force their liver to work overtime. This eventually causes severe liver damage in the form of chronic inflammation, scarring, tissue damage, or cancer. Because the liver is a vital part of routine body functions, this liver damage can cause several other health problems over time.

Heart Problems

Most drugs and alcohol present a threat to your cardiovascular health. Heart problems stemming from substance addiction range from an increased heart rate or abnormal blood pressure to a heart attack. Drugs and alcohol serve to weaken your heart over time, increasing your risk levels even more with long-term use. Additionally, drug users who utilize injections face an increased risk of collapsed veins or bacterial infections in the bloodstream.

Just as the psychological and physical effects of addiction reach every bodily function, the consequences of addiction stretch far beyond the user. Individuals who suffer from alcoholism or drug addiction are also likely to face problems with their finances, careers, relationship, or even criminal records. At Serenity Group, we know that addiction isn’t easy for anyone. If your addiction results in a DUI charge and SR22 insurance requirement, we’re here to help. We’ll find the best SR22 insurance quotes in California, Colorado, or wherever your charge exists. Let us take care of your insurance so you can focus on getting back on the road and on your way to recovery.


Why This Doctor Believes Addictions Start In Childhood

What causes drug addiction? One Canadian physician argues that the problem isn't the drugs themselves.

Dr. Gabor Maté believes -- based on research and his own experience working at harm reduction clinics in Vancouver's Downtown Eastside, a poor area that has one of the worst drug problems in North America -- that the root of addictive behaviors can be traced all the way back to childhood.

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience," Maté wrote in his 2010 bestseller, In the Realm of Hungry Ghosts: Close Encounters with Addiction. "A hurt is at the center of all addictive behaviors. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden -- but it’s there."

There is increasing interest in the medical field around the potential lifelong health outcomes of adverse childhood experiences. At least one critic of Mate's work has suggested that an exclusive focus on childhood harms is too limiting, and precludes "a more comprehensive and practicable view of addiction." A great deal of research supports the link between childhood trauma and substance abuse risk. However, it's important to remember there are many risk factors for addiction, including family history of addiction, mental illness and the use of habit-forming pharmaceuticals.

A long-outspoken proponent of mind-body approaches to health and disease, Maté has begun treating patients using ayahuasca, a hallucinogenic brew made from the bark of an Amazonian rainforest tree, which early research has shown could hold promise for treating addiction, depression and post-traumatic stress disorder. Because ayahuasca is a controlled substance, Health Canada has ordered that Maté refrain from using the substance in his work with addicts. The U.S. and other countries are continuing to examine its effects in observational studies, and while the findings are promising so far, the research is still young.

HuffPost Science caught up with Maté to learn more about his trauma-informed approach to understanding and treating addiction, and his optimism about the potential of ayahuasca and other psychedelics in therapeutic settings.

How do you define addiction?

It’s a complex process that involves brain, body, emotions, psychology and social relationships. The expression of addiction is any behavior where a person craves and finds temporary pleasure or relief in something, but suffers negative consequences as a result of and is unable to give up despite those negative consequences.

Addiction could be substance-related -- alcohol, cigarettes, heroin or cocaine -- but it could also be sex, gambling, eating, shopping, work, extreme sports, relationships, the Internet. It could be anything. So it’s not so much the activity per se but the question of, does it provide temporary relief or pleasure? Does it create craving when you don’t have it? Does it create negative consequences, and is it difficult to give up despite those consequences? If those are the case, it’s an addiction.

Does that mean that even something like heroin or cocaine isn't inherently addictive?

I’m saying that the substances are not in themselves addictive. It has to do with the availability of the target of the behavior and the susceptibility of the individual. So the real question is, what creates the susceptibility?

In your view, what are some of the social or environmental factors that might make an individual susceptible to addiction?

The single factor that’s at the core of all addictions is trauma. By trauma I mean emotional loss in childhood, and in the case of severe addicts, you can see -- and large-scale population studies show -- that there is significant childhood trauma such as family violence, addiction in the family, sexual and emotional abuse, physical abuse, a parent being mentally ill or in jail. These adverse childhood experiences have been shown to exponentially increase the risk of addiction later on in life. That’s one set of difficult experiences.

There’s another set of difficult experiences that’s a bit harder to distinguish, and that’s not when bad things happen but when good things don’t happen. A child has certain fundamental needs for emotional development and also for brain development. If you look at the human brain, it develops under the impact of the environment. The potentials are genetically set, but which genes are turned on and off depends very much on the environment. So for example, in the case of addiction, the brain’s reward circuitry is impaired… the person's circuits, which have to do with the chemical dopamine and which give you a sense of reward incentive and motivation, are not well-developed. Those circuits need the support of the environment to help them in their development, and the essential quality of the environment is a mutually responsive relationship with the parent or caregiver.

So in families where the parents are overly stressed or aren’t able to be emotionally present with the children, in the case of sensitive children, that can interfere with their brain development. The children will look for reward elsewhere. When we’re looking at psychological pain at the heart of all addictions and addictive behaviors, they have one intended purpose: to soothe pain or to escape from pain or stress. So whether we're looking at the psychological side of addiction, which is needing to escape from pain or stress, or the brain physiology side, which is the underdeveloped reward circuits in the brain, we're looking at the impact of childhood.

Would you say that addiction is a disease then, or is it just a coping mechanism?

That’s a complex question. Addiction has the features of a disease, if you look at it. Does it have dysfunctional physiological brain circuits? Yes, it does. Does it result in pathological effects? Yes, it does. Is it characterized by relapse? Yes, it is. But that doesn’t mean that it is only a disease. You can’t reduce it to a narrow medical model.

When we look at addiction as a physical disease, we don’t acknowledge the lived experience of the individual. The behaviors are just symptoms, they are not the core.

And I would argue that this is true even of cancer or asthma or autoimmune disease: What we call a disease is just the endpoint of a lifelong process. That’s when the medical system comes in and diagnoses the person with a disease. But where did it all come from? To understand that, you have to look at the person’s whole life. I don’t call it a disease, I call it a process that has some features of disease. It’s not a problem to talk about it in terms of a disease, but it’s not adequate.

When we look at addiction as a physical disease, we don’t acknowledge the lived experience of the individual. The behaviors are just symptoms, they are not the core.

One emerging way of treating addiction that does seem to address the lived experience of addicts and past experiences of trauma is through psychedelic-assisted psychotherapy, specifically using ayahuasca. What has your experience been like working with addicts using ayahuasca-based treatments?

I’ve worked clinically with people with addictions employing ayahuasca. It’s not a panacea, but the results are better than encouraging. We’ve had people give up alcoholism, sex addiction, smoking addiction and cocaine addiction.

I am convinced -- based on both international evidence and my own clinical experience -- that if we could provide a treatment approach that was trauma-informed,that provided a safe environment with good support and adept psychotherapy, in that context, the use of some psychedelics could greatly increase our success.

The reason for this is the way psychedelics work on the brain. It’s not some sort of a trip. It changes or causes new ways of people experiencing themselves, including how they experience their brains.

The results of studies conducted so far using psychedelic-assisted psychotherapy for treating addiction are very promising. Why has it taken so long to bring psychedelics into addiction treatment? Is it because we view these substances as “drugs” in the traditional sense?

Psychedelics have been used, particularly in the '60s but even before, for escape purposes. People can use MDMA or LSD to trip out, so naturally people think these are bad things. It really has to do with context, intention and guidance. The same substance can be very different in a different context, and with different intention and guidance.

Given the North American experience [compared to traditional healing use in some South American cultures], it’s unsurprising that people would see psychedelics as a bad thing. They need to get over that and look at the total reality. While it’s true that they’ve been used as drugs, we need to look at whether it’s possible, as is the case in many cultures, that they’ve been used in the very opposite way -- not just to escape reality but to become more connected to it.

When you lead ayahuasca-assisted treatments for individuals in addiction recovery, what does that look like?

I don’t lead the ayahuasca ceremonies because I’m not a shaman. In terms of setting intentions and debriefing people beforehand, and processing and integrating their experience afterward, that’s my role. It’s a great combination of uniting Western-based psychodynamics with shamanic spiritual practices. Unfortunately, there’s a lot of people out there who have ayahuasca experiences without that context, and it can be helpful or it can be very confusing and disturbing based on the context.

How have the people you’ve worked with described the ayahuasca experience?

The psychedelic experience is not necessarily a pleasant event -- it can bring up a lot of pain and a lot of fear. People can experience profound emotions of fear, dread, emotional pain, confusion -- all emotions that have been in them all their lives, they’ve just covered it up with various behaviors and compulsions. It just brings out whatever’s there. Psychedelic means “mind-manifesting” -- it manifests whatever’s in your mind that you weren’t aware was there.

It can also bring up memories of childhood trauma, which sometimes may be accurate. Sometimes they’re a bit dream-like, it’s that the emotion comes first and then the mind makes up a story around the emotion… There’s nothing made up about the emotions, but the specifics may or may not be accurate, but it doesn’t matter. What matters is that the person as an adult can experience it in a safe and compassionate setting they’re able to experience the pain they’ve been carrying all their lives and weren’t aware of, and then release it as a result.

With ayahuasca, people often say it can be like 10 years of psychotherapy in one week.

What do you think it will take for psychedelic-based psychotherapies to become available for people who could potentially benefit from them?

There are studies being done now on psilocybin for end-of-life anxiety at Johns Hopkins and elsewhere that are showing very encouraging results. There have been encouraging results using MDMA for veterans and others with post-traumatic stress disorder. We know from Latin American studies the value of ayahuasca in terms of addiction, and there is encouraging work with ibogaine for opiate addiction. Within the constrictions of a system that deems these substances of no medical benefit and makes them illegal, it’s great to see how much research is being done and how much conversation is being generated in medical and psychiatric and research circles.

We’re moving forward, and that’s a great thing, especially given the severe limitations of what the current medical system can achieve in terms of addictions and post-traumatic stress disorders. Again, the issue for me is, are there effective ways of working with people’s core traumas so that they can begin to release the effects of that trauma?

This interview has been lightly edited for length and clarity. To learn more about Maté's work, visit his website.


The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think

It is now one hundred years since drugs were first banned -- and all through this long century of waging war on drugs, we have been told a story about addiction by our teachers and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my new book, Chasing The Scream: The First And Last Days of the War on Drugs, to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong -- and there is a very different story waiting for us, if only we are ready to hear it.

If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I learned it from an extraordinary mixture of people I met on my travels. From the surviving friends of Billie Holiday, who helped me to learn how the founder of the war on drugs stalked and helped to kill her. From a Jewish doctor who was smuggled out of the Budapest ghetto as a baby, only to unlock the secrets of addiction as a grown man. From a transsexual crack dealer in Brooklyn who was conceived when his mother, a crack-addict, was raped by his father, an NYPD officer. From a man who was kept at the bottom of a well for two years by a torturing dictatorship, only to emerge to be elected President of Uruguay and to begin the last days of the war on drugs.

I had a quite personal reason to set out for these answers. One of my earliest memories as a kid is trying to wake up one of my relatives, and not being able to. Ever since then, I have been turning over the essential mystery of addiction in my mind -- what causes some people to become fixated on a drug or a behavior until they can't stop? How do we help those people to come back to us? As I got older, another of my close relatives developed a cocaine addiction, and I fell into a relationship with a heroin addict. I guess addiction felt like home to me.

If you had asked me what causes drug addiction at the start, I would have looked at you as if you were an idiot, and said: "Drugs. Duh." It's not difficult to grasp. I thought I had seen it in my own life. We can all explain it. Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That's what addiction means.

One of the ways this theory was first established is through rat experiments -- ones that were injected into the American psyche in the 1980s, in a famous advert by the Partnership for a Drug-Free America. You may remember it. The experiment is simple. Put a rat in a cage, alone, with two water bottles. One is just water. The other is water laced with heroin or cocaine. Almost every time you run this experiment, the rat will become obsessed with the drugged water, and keep coming back for more and more, until it kills itself.

The advert explains: "Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It's called cocaine. And it can do the same thing to you."

But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander noticed something odd about this experiment. The rat is put in the cage all alone. It has nothing to do but take the drugs. What would happen, he wondered, if we tried this differently? So Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat-food and tunnels to scamper down and plenty of friends: everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn't know what was in them. But what happened next was startling.

The rats with good lives didn't like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

At first, I thought this was merely a quirk of rats, until I discovered that there was -- at the same time as the Rat Park experiment -- a helpful human equivalent taking place. It was called the Vietnam War. Time magazine reported using heroin was "as common as chewing gum" among U.S. soldiers, and there is solid evidence to back this up: some 20 percent of U.S. soldiers had become addicted to heroin there, according to a study published in the Archives of General Psychiatry. Many people were understandably terrified they believed a huge number of addicts were about to head home when the war ended.

But in fact some 95 percent of the addicted soldiers -- according to the same study -- simply stopped. Very few had rehab. They shifted from a terrifying cage back to a pleasant one, so didn't want the drug any more.

Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It's not you. It's your cage.

After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days -- if anything can hook you, it's that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can't recover? Do the drugs take you over? What happened is -- again -- striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)

When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don't seem to make sense -- unless you take account of this new approach.

Here's one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right -- it's the drugs that cause it they make your body need them -- then it's obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit.

But here's the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected.

If you still believe -- as I used to -- that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander's theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It's how we get our satisfaction. If we can't connect with each other, we will connect with anything we can find -- the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about 'addiction' altogether, and instead call it 'bonding.' A heroin addict has bonded with heroin because she couldn't bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.

When I learned all this, I found it slowly persuading me, but I still couldn't shake off a nagging doubt. Are these scientists saying chemical hooks make no difference? It was explained to me -- you can become addicted to gambling, and nobody thinks you inject a pack of cards into your veins. You can have all the addiction, and none of the chemical hooks. I went to a Gamblers' Anonymous meeting in Las Vegas (with the permission of everyone present, who knew I was there to observe) and they were as plainly addicted as the cocaine and heroin addicts I have known in my life. Yet there are no chemical hooks on a craps table.

But still, surely, I asked, there is some role for the chemicals? It turns out there is an experiment which gives us the answer to this in quite precise terms, which I learned about in Richard DeGrandpre's book The Cult of Pharmacology.

Everyone agrees cigarette smoking is one of the most addictive processes around. The chemical hooks in tobacco come from a drug inside it called nicotine. So when nicotine patches were developed in the early 1990s, there was a huge surge of optimism -- cigarette smokers could get all of their chemical hooks, without the other filthy (and deadly) effects of cigarette smoking. They would be freed.

But the Office of the Surgeon General has found that just 17.7 percent of cigarette smokers are able to stop using nicotine patches. That's not nothing. If the chemicals drive 17.7 percent of addiction, as this shows, that's still millions of lives ruined globally. But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture.

This has huge implications for the one-hundred-year-old war on drugs. This massive war -- which, as I saw, kills people from the malls of Mexico to the streets of Liverpool -- is based on the claim that we need to physically eradicate a whole array of chemicals because they hijack people's brains and cause addiction. But if drugs aren't the driver of addiction -- if, in fact, it is disconnection that drives addiction -- then this makes no sense.

Ironically, the war on drugs actually increases all those larger drivers of addiction. For example, I went to a prison in Arizona -- 'Tent City' -- where inmates are detained in tiny stone isolation cages ('The Hole') for weeks and weeks on end to punish them for drug use. It is as close to a human recreation of the cages that guaranteed deadly addiction in rats as I can imagine. And when those prisoners get out, they will be unemployable because of their criminal record -- guaranteeing they with be cut off even more. I watched this playing out in the human stories I met across the world.

There is an alternative. You can build a system that is designed to help drug addicts to reconnect with the world -- and so leave behind their addictions.

This isn't theoretical. It is happening. I have seen it. Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them -- to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings, after years of trauma and stunning them into silence with drugs.

One example I learned about was a group of addicts who were given a loan to set up a removals firm. Suddenly, they were a group, all bonded to each other, and to the society, and responsible for each other's care.

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I'll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country's top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass -- and he now hopes the whole world will follow Portugal's example.

This isn't only relevant to the addicts I love. It is relevant to all of us, because it forces us to think differently about ourselves. Human beings are bonding animals. We need to connect and love. The wisest sentence of the twentieth century was E.M. Forster's -- "only connect." But we have created an environment and a culture that cut us off from connection, or offer only the parody of it offered by the Internet. The rise of addiction is a symptom of a deeper sickness in the way we live -- constantly directing our gaze towards the next shiny object we should buy, rather than the human beings all around us.

The writer George Monbiot has called this "the age of loneliness." We have created human societies where it is easier for people to become cut off from all human connections than ever before. Bruce Alexander -- the creator of Rat Park -- told me that for too long, we have talked exclusively about individual recovery from addiction. We need now to talk about social recovery -- how we all recover, together, from the sickness of isolation that is sinking on us like a thick fog.

But this new evidence isn't just a challenge to us politically. It doesn't just force us to change our minds. It forces us to change our hearts.

Loving an addict is really hard. When I looked at the addicts I love, it was always tempting to follow the tough love advice doled out by reality shows like Intervention -- tell the addict to shape up, or cut them off. Their message is that an addict who won't stop should be shunned. It's the logic of the drug war, imported into our private lives. But in fact, I learned, that will only deepen their addiction -- and you may lose them altogether. I came home determined to tie the addicts in my life closer to me than ever -- to let them know I love them unconditionally, whether they stop, or whether they can't.

When I returned from my long journey, I looked at my ex-boyfriend, in withdrawal, trembling on my spare bed, and I thought about him differently. For a century now, we have been singing war songs about addicts. It occurred to me as I wiped his brow, we should have been singing love songs to them all along.

The full story of Johann Hari's journey -- told through the stories of the people he met -- can be read in Chasing The Scream: The First and Last Days of the War on Drugs, published by Bloomsbury. The book has been praised by everyone from Elton John to Glenn Greenwald to Naomi Klein. You can buy it at all good bookstores and read more at www.chasingthescream.com.

Johann will be speaking on August 26th in Edinburgh, in early September in Sydney, Brisbane and Melbourne, and in mid-September in Mexico City. For details of these events go to www.chasingthescream.com.

The full references and sources for all the information cited in this article can be found in the book's extensive end-notes.


Defining Features

Not everyone in the medical community is convinced that sex addiction is an established diagnosis.   Because of this, it is not listed as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA).

As a result, the diagnostic criteria for a sex addiction is often vague and subjective. However, several defining features common to people with sex addiction have been suggested.:

  • Sex dominates the person's life to the exclusion of other activities.
  • Sexual activities may be inappropriate and/or risky and may include exhibitionism, public sex, sex with prostitutes, or regular attendance at sex clubs.
  • The constant urge for sex is typically interspersed with feelings of regret, anxiety, depression, or shame.
  • The person engages in other forms of sex when alone, including phone sex, pornography, or computer sex.
  • The person engages in sex with multiple partners and/or has extramarital affairs.
  • The person masturbates habitually when alone.

In fact, a sexual addiction is most often characterized by a vicious circle of hypersexuality and low self-esteem.   Although sex can bring short-term relief, the harm to the person's psychological well-being will often increase and worsen over time.

A person does not have to engage in extreme or "strange" sex to have an addiction. They will simply be unable to stop themselves despite the harm that they know may result from their behavior.


What Are The 5 Stages of Addiction?

There can be some overlap between the various levels of addiction, and not everyone will follow the same path through each phase.

The roadmap below outlines the 5 stages of addiction that most people follow from the first time they use a substance until it becomes an addictive behavior.

1. The First Stage of Addiction – First Use or Experimentation

Everyone remembers the first time they got drunk or the first time they got high.

Most people think the first stage of addiction is considered “experimentation.” In actuality first use does encompass some form of experimentation with alcohol or drugs for many people.

But it also includes those people who are taking a medication that was medically prescribed by their physician for a specific issue.

People who take a prescribed medication aren’t experimenting with getting high and they are simply following a doctor’s orders for health reasons.

Whether the first use is out of a sense of adventure, peer pressure, or a medical necessity, people will learn and understand how the substance makes them feel through this first-time use.

2. Continued Use

Continued use of a substance, in the case of a person with a prescription, might be out of a requirement or feeling the need to use the medication.

For an individual that experimented not too long ago and returned to the substance, it’s clearer that they like how the drug makes them feel.

Also, in the continued use stage, a person is likely to notice that they’re not bouncing back as quickly after getting high or using the substance. This is because it takes the brain longer to chemically repair itself and return to a normal balance of homeostasis.

It’s important to note, the continued use phase can go on for a very long time without ever causing any problems for majority of people.

3. Tolerance is the Third Stage of Addiction

Tolerance occurs after a period of continued use of drugs or alcohol, and the speed and degree of a tolerance will vary among each person and often depends on the type of substance they are using.

Building up a tolerance to drugs or alcohol is one of the first warning signs of addiction.

When a person experiences a tolerance to something, it means the brain and body have adjusted to the drug and it now takes a greater amount to feel the same effects of it that they previously felt.

A person that has developed a tolerance to a prescription painkiller their doctor prescribed might start to notice that the dosage they have been taking no longer dulls their pain as effectively as it did when they first started using it.

When people develop a tolerance to alcohol, they realize they must drink more to feel drunk, even though their blood alcohol concentration doesn’t change. They will still be considered legally intoxicated after the same amount of drinks as when they first began drinking.

4. Dependence

Dependence is the stage of addiction where a substance user might first notice they become physically ill without alcohol or drugs, perhaps even developing serious withdrawal symptoms. There are several biological elements in play here.

Chemically, the brain has become accustomed to the substance and doesn’t function well without it.

This also presents as a physical symptom, sending a person into withdrawal where they can experience flu-like symptoms when not using opiates, or sweats and shakiness when they aren’t drinking alcohol.

The negative signs and symptoms of dependence often disappear when a person is able to get a drink or a fix of their drug of choice.

When a dependence to drugs or alcohol occurs, many individuals don’t feel normal if they’re sober and not using any substances. This stage of addiction is a possible sign the disease is probably starting to take hold, both physically and psychologically.

5. Addiction

With the last stage of addiction, individuals find it nearly impossible to stop using drugs or alcohol, even when they no longer enjoy it or their behavior has caused serious life problems.

In fact, this stage is one of the telltale signs of addiction and goes back to the definition provided above that, “people will compulsively seek and use drugs or alcohol despite harmful consequences.”

Many people might go for periods of time where they don’t use any drugs or alcohol, but they are unable to stop completely by themselves, even though things seemed to be going well.

On the other side of the coin, a person in the throws of addiction who’s lost everything important in their life might be in total denial. They are unwilling or unable to face the disease or see how it is impacting their life.

Some might enjoy it too much to stop despite any negative ramifications, while others simply see it as a normal part of their life that is under their control, even when it isn’t.

Many of these people say they can stop at any time, and others will make jokes about how much they can drink or how many drugs they take.

Sure, addiction is a disease. But it is the only disease that tries to convince you that you don’t have it. This is one reason why many people fail to seek help or treatment.


The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think

It is now one hundred years since drugs were first banned -- and all through this long century of waging war on drugs, we have been told a story about addiction by our teachers and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my new book, Chasing The Scream: The First And Last Days of the War on Drugs, to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong -- and there is a very different story waiting for us, if only we are ready to hear it.

If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I learned it from an extraordinary mixture of people I met on my travels. From the surviving friends of Billie Holiday, who helped me to learn how the founder of the war on drugs stalked and helped to kill her. From a Jewish doctor who was smuggled out of the Budapest ghetto as a baby, only to unlock the secrets of addiction as a grown man. From a transsexual crack dealer in Brooklyn who was conceived when his mother, a crack-addict, was raped by his father, an NYPD officer. From a man who was kept at the bottom of a well for two years by a torturing dictatorship, only to emerge to be elected President of Uruguay and to begin the last days of the war on drugs.

I had a quite personal reason to set out for these answers. One of my earliest memories as a kid is trying to wake up one of my relatives, and not being able to. Ever since then, I have been turning over the essential mystery of addiction in my mind -- what causes some people to become fixated on a drug or a behavior until they can't stop? How do we help those people to come back to us? As I got older, another of my close relatives developed a cocaine addiction, and I fell into a relationship with a heroin addict. I guess addiction felt like home to me.

If you had asked me what causes drug addiction at the start, I would have looked at you as if you were an idiot, and said: "Drugs. Duh." It's not difficult to grasp. I thought I had seen it in my own life. We can all explain it. Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That's what addiction means.

One of the ways this theory was first established is through rat experiments -- ones that were injected into the American psyche in the 1980s, in a famous advert by the Partnership for a Drug-Free America. You may remember it. The experiment is simple. Put a rat in a cage, alone, with two water bottles. One is just water. The other is water laced with heroin or cocaine. Almost every time you run this experiment, the rat will become obsessed with the drugged water, and keep coming back for more and more, until it kills itself.

The advert explains: "Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It's called cocaine. And it can do the same thing to you."

But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander noticed something odd about this experiment. The rat is put in the cage all alone. It has nothing to do but take the drugs. What would happen, he wondered, if we tried this differently? So Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat-food and tunnels to scamper down and plenty of friends: everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn't know what was in them. But what happened next was startling.

The rats with good lives didn't like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

At first, I thought this was merely a quirk of rats, until I discovered that there was -- at the same time as the Rat Park experiment -- a helpful human equivalent taking place. It was called the Vietnam War. Time magazine reported using heroin was "as common as chewing gum" among U.S. soldiers, and there is solid evidence to back this up: some 20 percent of U.S. soldiers had become addicted to heroin there, according to a study published in the Archives of General Psychiatry. Many people were understandably terrified they believed a huge number of addicts were about to head home when the war ended.

But in fact some 95 percent of the addicted soldiers -- according to the same study -- simply stopped. Very few had rehab. They shifted from a terrifying cage back to a pleasant one, so didn't want the drug any more.

Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It's not you. It's your cage.

After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days -- if anything can hook you, it's that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can't recover? Do the drugs take you over? What happened is -- again -- striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)

When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don't seem to make sense -- unless you take account of this new approach.

Here's one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right -- it's the drugs that cause it they make your body need them -- then it's obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit.

But here's the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected.

If you still believe -- as I used to -- that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander's theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It's how we get our satisfaction. If we can't connect with each other, we will connect with anything we can find -- the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about 'addiction' altogether, and instead call it 'bonding.' A heroin addict has bonded with heroin because she couldn't bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.

When I learned all this, I found it slowly persuading me, but I still couldn't shake off a nagging doubt. Are these scientists saying chemical hooks make no difference? It was explained to me -- you can become addicted to gambling, and nobody thinks you inject a pack of cards into your veins. You can have all the addiction, and none of the chemical hooks. I went to a Gamblers' Anonymous meeting in Las Vegas (with the permission of everyone present, who knew I was there to observe) and they were as plainly addicted as the cocaine and heroin addicts I have known in my life. Yet there are no chemical hooks on a craps table.

But still, surely, I asked, there is some role for the chemicals? It turns out there is an experiment which gives us the answer to this in quite precise terms, which I learned about in Richard DeGrandpre's book The Cult of Pharmacology.

Everyone agrees cigarette smoking is one of the most addictive processes around. The chemical hooks in tobacco come from a drug inside it called nicotine. So when nicotine patches were developed in the early 1990s, there was a huge surge of optimism -- cigarette smokers could get all of their chemical hooks, without the other filthy (and deadly) effects of cigarette smoking. They would be freed.

But the Office of the Surgeon General has found that just 17.7 percent of cigarette smokers are able to stop using nicotine patches. That's not nothing. If the chemicals drive 17.7 percent of addiction, as this shows, that's still millions of lives ruined globally. But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture.

This has huge implications for the one-hundred-year-old war on drugs. This massive war -- which, as I saw, kills people from the malls of Mexico to the streets of Liverpool -- is based on the claim that we need to physically eradicate a whole array of chemicals because they hijack people's brains and cause addiction. But if drugs aren't the driver of addiction -- if, in fact, it is disconnection that drives addiction -- then this makes no sense.

Ironically, the war on drugs actually increases all those larger drivers of addiction. For example, I went to a prison in Arizona -- 'Tent City' -- where inmates are detained in tiny stone isolation cages ('The Hole') for weeks and weeks on end to punish them for drug use. It is as close to a human recreation of the cages that guaranteed deadly addiction in rats as I can imagine. And when those prisoners get out, they will be unemployable because of their criminal record -- guaranteeing they with be cut off even more. I watched this playing out in the human stories I met across the world.

There is an alternative. You can build a system that is designed to help drug addicts to reconnect with the world -- and so leave behind their addictions.

This isn't theoretical. It is happening. I have seen it. Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them -- to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings, after years of trauma and stunning them into silence with drugs.

One example I learned about was a group of addicts who were given a loan to set up a removals firm. Suddenly, they were a group, all bonded to each other, and to the society, and responsible for each other's care.

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I'll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country's top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass -- and he now hopes the whole world will follow Portugal's example.

This isn't only relevant to the addicts I love. It is relevant to all of us, because it forces us to think differently about ourselves. Human beings are bonding animals. We need to connect and love. The wisest sentence of the twentieth century was E.M. Forster's -- "only connect." But we have created an environment and a culture that cut us off from connection, or offer only the parody of it offered by the Internet. The rise of addiction is a symptom of a deeper sickness in the way we live -- constantly directing our gaze towards the next shiny object we should buy, rather than the human beings all around us.

The writer George Monbiot has called this "the age of loneliness." We have created human societies where it is easier for people to become cut off from all human connections than ever before. Bruce Alexander -- the creator of Rat Park -- told me that for too long, we have talked exclusively about individual recovery from addiction. We need now to talk about social recovery -- how we all recover, together, from the sickness of isolation that is sinking on us like a thick fog.

But this new evidence isn't just a challenge to us politically. It doesn't just force us to change our minds. It forces us to change our hearts.

Loving an addict is really hard. When I looked at the addicts I love, it was always tempting to follow the tough love advice doled out by reality shows like Intervention -- tell the addict to shape up, or cut them off. Their message is that an addict who won't stop should be shunned. It's the logic of the drug war, imported into our private lives. But in fact, I learned, that will only deepen their addiction -- and you may lose them altogether. I came home determined to tie the addicts in my life closer to me than ever -- to let them know I love them unconditionally, whether they stop, or whether they can't.

When I returned from my long journey, I looked at my ex-boyfriend, in withdrawal, trembling on my spare bed, and I thought about him differently. For a century now, we have been singing war songs about addicts. It occurred to me as I wiped his brow, we should have been singing love songs to them all along.

The full story of Johann Hari's journey -- told through the stories of the people he met -- can be read in Chasing The Scream: The First and Last Days of the War on Drugs, published by Bloomsbury. The book has been praised by everyone from Elton John to Glenn Greenwald to Naomi Klein. You can buy it at all good bookstores and read more at www.chasingthescream.com.

Johann will be speaking on August 26th in Edinburgh, in early September in Sydney, Brisbane and Melbourne, and in mid-September in Mexico City. For details of these events go to www.chasingthescream.com.

The full references and sources for all the information cited in this article can be found in the book's extensive end-notes.


Physical Effects of Addiction

While many of the primary effects of addiction occur in the brain, the rest of the body can suffer as well. Substance abuse weakens the immune system and leaves the body more vulnerable to various diseases and infections. Drug use—especially through needles—increases an individual’s chance of contracting HIV, hepatitis, or other infectious diseases. Other physical effects of addiction include abdominal pain, digestive issues, trouble sleeping, or even seizures and other forms of brain damage. Addictive substances can impact every part of the body even beyond the following common issues.

Kidney Damage

Drugs can harm the kidneys both directly and indirectly. Many symptoms of drug use—such as dehydration, muscle breakdown, and increased body temperature—can contribute to kidney damage. This damage worsens as these symptoms persist over time. Unfortunately, it is relatively common for long-term drug users to experience kidney failure or other forms of kidney damage. The same is true for individuals who regularly consume a large amount of alcohol. Heavy drinking increases an individual’s risk of chronic kidney disease.

Liver Failure

Liver damage is a well-known consequence of heavy drinking. However, both alcohol and drug addiction can lead to serious complications and even liver failure. The liver is responsible for clearing toxins from the bloodstream. When an individual partakes in the use of drugs or alcohol on a regular basis, they force their liver to work overtime. This eventually causes severe liver damage in the form of chronic inflammation, scarring, tissue damage, or cancer. Because the liver is a vital part of routine body functions, this liver damage can cause several other health problems over time.

Heart Problems

Most drugs and alcohol present a threat to your cardiovascular health. Heart problems stemming from substance addiction range from an increased heart rate or abnormal blood pressure to a heart attack. Drugs and alcohol serve to weaken your heart over time, increasing your risk levels even more with long-term use. Additionally, drug users who utilize injections face an increased risk of collapsed veins or bacterial infections in the bloodstream.

Just as the psychological and physical effects of addiction reach every bodily function, the consequences of addiction stretch far beyond the user. Individuals who suffer from alcoholism or drug addiction are also likely to face problems with their finances, careers, relationship, or even criminal records. At Serenity Group, we know that addiction isn’t easy for anyone. If your addiction results in a DUI charge and SR22 insurance requirement, we’re here to help. We’ll find the best SR22 insurance quotes in California, Colorado, or wherever your charge exists. Let us take care of your insurance so you can focus on getting back on the road and on your way to recovery.


What Are The 5 Stages of Addiction?

There can be some overlap between the various levels of addiction, and not everyone will follow the same path through each phase.

The roadmap below outlines the 5 stages of addiction that most people follow from the first time they use a substance until it becomes an addictive behavior.

1. The First Stage of Addiction – First Use or Experimentation

Everyone remembers the first time they got drunk or the first time they got high.

Most people think the first stage of addiction is considered “experimentation.” In actuality first use does encompass some form of experimentation with alcohol or drugs for many people.

But it also includes those people who are taking a medication that was medically prescribed by their physician for a specific issue.

People who take a prescribed medication aren’t experimenting with getting high and they are simply following a doctor’s orders for health reasons.

Whether the first use is out of a sense of adventure, peer pressure, or a medical necessity, people will learn and understand how the substance makes them feel through this first-time use.

2. Continued Use

Continued use of a substance, in the case of a person with a prescription, might be out of a requirement or feeling the need to use the medication.

For an individual that experimented not too long ago and returned to the substance, it’s clearer that they like how the drug makes them feel.

Also, in the continued use stage, a person is likely to notice that they’re not bouncing back as quickly after getting high or using the substance. This is because it takes the brain longer to chemically repair itself and return to a normal balance of homeostasis.

It’s important to note, the continued use phase can go on for a very long time without ever causing any problems for majority of people.

3. Tolerance is the Third Stage of Addiction

Tolerance occurs after a period of continued use of drugs or alcohol, and the speed and degree of a tolerance will vary among each person and often depends on the type of substance they are using.

Building up a tolerance to drugs or alcohol is one of the first warning signs of addiction.

When a person experiences a tolerance to something, it means the brain and body have adjusted to the drug and it now takes a greater amount to feel the same effects of it that they previously felt.

A person that has developed a tolerance to a prescription painkiller their doctor prescribed might start to notice that the dosage they have been taking no longer dulls their pain as effectively as it did when they first started using it.

When people develop a tolerance to alcohol, they realize they must drink more to feel drunk, even though their blood alcohol concentration doesn’t change. They will still be considered legally intoxicated after the same amount of drinks as when they first began drinking.

4. Dependence

Dependence is the stage of addiction where a substance user might first notice they become physically ill without alcohol or drugs, perhaps even developing serious withdrawal symptoms. There are several biological elements in play here.

Chemically, the brain has become accustomed to the substance and doesn’t function well without it.

This also presents as a physical symptom, sending a person into withdrawal where they can experience flu-like symptoms when not using opiates, or sweats and shakiness when they aren’t drinking alcohol.

The negative signs and symptoms of dependence often disappear when a person is able to get a drink or a fix of their drug of choice.

When a dependence to drugs or alcohol occurs, many individuals don’t feel normal if they’re sober and not using any substances. This stage of addiction is a possible sign the disease is probably starting to take hold, both physically and psychologically.

5. Addiction

With the last stage of addiction, individuals find it nearly impossible to stop using drugs or alcohol, even when they no longer enjoy it or their behavior has caused serious life problems.

In fact, this stage is one of the telltale signs of addiction and goes back to the definition provided above that, “people will compulsively seek and use drugs or alcohol despite harmful consequences.”

Many people might go for periods of time where they don’t use any drugs or alcohol, but they are unable to stop completely by themselves, even though things seemed to be going well.

On the other side of the coin, a person in the throws of addiction who’s lost everything important in their life might be in total denial. They are unwilling or unable to face the disease or see how it is impacting their life.

Some might enjoy it too much to stop despite any negative ramifications, while others simply see it as a normal part of their life that is under their control, even when it isn’t.

Many of these people say they can stop at any time, and others will make jokes about how much they can drink or how many drugs they take.

Sure, addiction is a disease. But it is the only disease that tries to convince you that you don’t have it. This is one reason why many people fail to seek help or treatment.


Forex Psychology – Trading Can Be Addictive

‘Addict’ is a dirty word associated with the perceived down and outs of society, those who sleep on a park bench or live from one needle to another. But addiction invades slowly and surreptitiously and can hit anyone at anytime, although some are more susceptible than others. Genetic components definitely can and do play a role. Research has shown that the brains of addicts metabolize and process their drug quite differently from non-addicts. There is reason to believe that one part of the brain in particular is involved and that when it has been activated, the addiction takes over and stimulates uncontrollable behaviors.

Trading involves intense exercise of the brain and the will. It constitutes constant analysis and problem solving as performance-based skills become increasingly fine-tuned. Serious players of chess, poker and successful athletes develop and grow in similar ways.

However, trading can become an instrument for destroying mind, soul, body and lives. For trading can become an addictive activity. Whereas an addiction to alcohol and other drugs are substance addictions, an addiction to trading is a process addiction and thus much more difficult to spot and overcome. There is a great deal of research in this area that has yet to be done but consider the following:


Defining Features

Not everyone in the medical community is convinced that sex addiction is an established diagnosis.   Because of this, it is not listed as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA).

As a result, the diagnostic criteria for a sex addiction is often vague and subjective. However, several defining features common to people with sex addiction have been suggested.:

  • Sex dominates the person's life to the exclusion of other activities.
  • Sexual activities may be inappropriate and/or risky and may include exhibitionism, public sex, sex with prostitutes, or regular attendance at sex clubs.
  • The constant urge for sex is typically interspersed with feelings of regret, anxiety, depression, or shame.
  • The person engages in other forms of sex when alone, including phone sex, pornography, or computer sex.
  • The person engages in sex with multiple partners and/or has extramarital affairs.
  • The person masturbates habitually when alone.

In fact, a sexual addiction is most often characterized by a vicious circle of hypersexuality and low self-esteem.   Although sex can bring short-term relief, the harm to the person's psychological well-being will often increase and worsen over time.

A person does not have to engage in extreme or "strange" sex to have an addiction. They will simply be unable to stop themselves despite the harm that they know may result from their behavior.


Actions Speak Louder Than Words

Effective communication in the workplace doesn&rsquot have to be challenging, but it does have to be intentional. Knowledge can only take us so far, but once again, knowing something is very different than putting it into action.

Just like riding a bike, the more often you do it, the easier it becomes. Master communicators are phenomenal listeners, which allows them to be effective communicators in the workplace and in life. If you genuinely want to own your communication, you must implement this information today and learn how to improve your listening skills.

Choose your words carefully, listen intently, and most of all, be present in the moment&mdashbecause that&rsquos what master communicators do, and you can do it, too!


Why This Doctor Believes Addictions Start In Childhood

What causes drug addiction? One Canadian physician argues that the problem isn't the drugs themselves.

Dr. Gabor Maté believes -- based on research and his own experience working at harm reduction clinics in Vancouver's Downtown Eastside, a poor area that has one of the worst drug problems in North America -- that the root of addictive behaviors can be traced all the way back to childhood.

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience," Maté wrote in his 2010 bestseller, In the Realm of Hungry Ghosts: Close Encounters with Addiction. "A hurt is at the center of all addictive behaviors. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden -- but it’s there."

There is increasing interest in the medical field around the potential lifelong health outcomes of adverse childhood experiences. At least one critic of Mate's work has suggested that an exclusive focus on childhood harms is too limiting, and precludes "a more comprehensive and practicable view of addiction." A great deal of research supports the link between childhood trauma and substance abuse risk. However, it's important to remember there are many risk factors for addiction, including family history of addiction, mental illness and the use of habit-forming pharmaceuticals.

A long-outspoken proponent of mind-body approaches to health and disease, Maté has begun treating patients using ayahuasca, a hallucinogenic brew made from the bark of an Amazonian rainforest tree, which early research has shown could hold promise for treating addiction, depression and post-traumatic stress disorder. Because ayahuasca is a controlled substance, Health Canada has ordered that Maté refrain from using the substance in his work with addicts. The U.S. and other countries are continuing to examine its effects in observational studies, and while the findings are promising so far, the research is still young.

HuffPost Science caught up with Maté to learn more about his trauma-informed approach to understanding and treating addiction, and his optimism about the potential of ayahuasca and other psychedelics in therapeutic settings.

How do you define addiction?

It’s a complex process that involves brain, body, emotions, psychology and social relationships. The expression of addiction is any behavior where a person craves and finds temporary pleasure or relief in something, but suffers negative consequences as a result of and is unable to give up despite those negative consequences.

Addiction could be substance-related -- alcohol, cigarettes, heroin or cocaine -- but it could also be sex, gambling, eating, shopping, work, extreme sports, relationships, the Internet. It could be anything. So it’s not so much the activity per se but the question of, does it provide temporary relief or pleasure? Does it create craving when you don’t have it? Does it create negative consequences, and is it difficult to give up despite those consequences? If those are the case, it’s an addiction.

Does that mean that even something like heroin or cocaine isn't inherently addictive?

I’m saying that the substances are not in themselves addictive. It has to do with the availability of the target of the behavior and the susceptibility of the individual. So the real question is, what creates the susceptibility?

In your view, what are some of the social or environmental factors that might make an individual susceptible to addiction?

The single factor that’s at the core of all addictions is trauma. By trauma I mean emotional loss in childhood, and in the case of severe addicts, you can see -- and large-scale population studies show -- that there is significant childhood trauma such as family violence, addiction in the family, sexual and emotional abuse, physical abuse, a parent being mentally ill or in jail. These adverse childhood experiences have been shown to exponentially increase the risk of addiction later on in life. That’s one set of difficult experiences.

There’s another set of difficult experiences that’s a bit harder to distinguish, and that’s not when bad things happen but when good things don’t happen. A child has certain fundamental needs for emotional development and also for brain development. If you look at the human brain, it develops under the impact of the environment. The potentials are genetically set, but which genes are turned on and off depends very much on the environment. So for example, in the case of addiction, the brain’s reward circuitry is impaired… the person's circuits, which have to do with the chemical dopamine and which give you a sense of reward incentive and motivation, are not well-developed. Those circuits need the support of the environment to help them in their development, and the essential quality of the environment is a mutually responsive relationship with the parent or caregiver.

So in families where the parents are overly stressed or aren’t able to be emotionally present with the children, in the case of sensitive children, that can interfere with their brain development. The children will look for reward elsewhere. When we’re looking at psychological pain at the heart of all addictions and addictive behaviors, they have one intended purpose: to soothe pain or to escape from pain or stress. So whether we're looking at the psychological side of addiction, which is needing to escape from pain or stress, or the brain physiology side, which is the underdeveloped reward circuits in the brain, we're looking at the impact of childhood.

Would you say that addiction is a disease then, or is it just a coping mechanism?

That’s a complex question. Addiction has the features of a disease, if you look at it. Does it have dysfunctional physiological brain circuits? Yes, it does. Does it result in pathological effects? Yes, it does. Is it characterized by relapse? Yes, it is. But that doesn’t mean that it is only a disease. You can’t reduce it to a narrow medical model.

When we look at addiction as a physical disease, we don’t acknowledge the lived experience of the individual. The behaviors are just symptoms, they are not the core.

And I would argue that this is true even of cancer or asthma or autoimmune disease: What we call a disease is just the endpoint of a lifelong process. That’s when the medical system comes in and diagnoses the person with a disease. But where did it all come from? To understand that, you have to look at the person’s whole life. I don’t call it a disease, I call it a process that has some features of disease. It’s not a problem to talk about it in terms of a disease, but it’s not adequate.

When we look at addiction as a physical disease, we don’t acknowledge the lived experience of the individual. The behaviors are just symptoms, they are not the core.

One emerging way of treating addiction that does seem to address the lived experience of addicts and past experiences of trauma is through psychedelic-assisted psychotherapy, specifically using ayahuasca. What has your experience been like working with addicts using ayahuasca-based treatments?

I’ve worked clinically with people with addictions employing ayahuasca. It’s not a panacea, but the results are better than encouraging. We’ve had people give up alcoholism, sex addiction, smoking addiction and cocaine addiction.

I am convinced -- based on both international evidence and my own clinical experience -- that if we could provide a treatment approach that was trauma-informed,that provided a safe environment with good support and adept psychotherapy, in that context, the use of some psychedelics could greatly increase our success.

The reason for this is the way psychedelics work on the brain. It’s not some sort of a trip. It changes or causes new ways of people experiencing themselves, including how they experience their brains.

The results of studies conducted so far using psychedelic-assisted psychotherapy for treating addiction are very promising. Why has it taken so long to bring psychedelics into addiction treatment? Is it because we view these substances as “drugs” in the traditional sense?

Psychedelics have been used, particularly in the '60s but even before, for escape purposes. People can use MDMA or LSD to trip out, so naturally people think these are bad things. It really has to do with context, intention and guidance. The same substance can be very different in a different context, and with different intention and guidance.

Given the North American experience [compared to traditional healing use in some South American cultures], it’s unsurprising that people would see psychedelics as a bad thing. They need to get over that and look at the total reality. While it’s true that they’ve been used as drugs, we need to look at whether it’s possible, as is the case in many cultures, that they’ve been used in the very opposite way -- not just to escape reality but to become more connected to it.

When you lead ayahuasca-assisted treatments for individuals in addiction recovery, what does that look like?

I don’t lead the ayahuasca ceremonies because I’m not a shaman. In terms of setting intentions and debriefing people beforehand, and processing and integrating their experience afterward, that’s my role. It’s a great combination of uniting Western-based psychodynamics with shamanic spiritual practices. Unfortunately, there’s a lot of people out there who have ayahuasca experiences without that context, and it can be helpful or it can be very confusing and disturbing based on the context.

How have the people you’ve worked with described the ayahuasca experience?

The psychedelic experience is not necessarily a pleasant event -- it can bring up a lot of pain and a lot of fear. People can experience profound emotions of fear, dread, emotional pain, confusion -- all emotions that have been in them all their lives, they’ve just covered it up with various behaviors and compulsions. It just brings out whatever’s there. Psychedelic means “mind-manifesting” -- it manifests whatever’s in your mind that you weren’t aware was there.

It can also bring up memories of childhood trauma, which sometimes may be accurate. Sometimes they’re a bit dream-like, it’s that the emotion comes first and then the mind makes up a story around the emotion… There’s nothing made up about the emotions, but the specifics may or may not be accurate, but it doesn’t matter. What matters is that the person as an adult can experience it in a safe and compassionate setting they’re able to experience the pain they’ve been carrying all their lives and weren’t aware of, and then release it as a result.

With ayahuasca, people often say it can be like 10 years of psychotherapy in one week.

What do you think it will take for psychedelic-based psychotherapies to become available for people who could potentially benefit from them?

There are studies being done now on psilocybin for end-of-life anxiety at Johns Hopkins and elsewhere that are showing very encouraging results. There have been encouraging results using MDMA for veterans and others with post-traumatic stress disorder. We know from Latin American studies the value of ayahuasca in terms of addiction, and there is encouraging work with ibogaine for opiate addiction. Within the constrictions of a system that deems these substances of no medical benefit and makes them illegal, it’s great to see how much research is being done and how much conversation is being generated in medical and psychiatric and research circles.

We’re moving forward, and that’s a great thing, especially given the severe limitations of what the current medical system can achieve in terms of addictions and post-traumatic stress disorders. Again, the issue for me is, are there effective ways of working with people’s core traumas so that they can begin to release the effects of that trauma?

This interview has been lightly edited for length and clarity. To learn more about Maté's work, visit his website.


Compulsive Sexual Behavior Is Now Recognized as a Disorder, But It isn’t the Same as Sex Addiction

Though the concept of sex addiction has been a subject of debate for some time, there actually hasn't been an official diagnosis that addresses problematic sexual behavior—until now.

Last month, the World Health Organization (WHO) released the proposal for the 11th edition of the International Classification of Diseases (ICD-11), the first revision of the global standard diagnostic catalogue since 1990. And among the proposed changes is the addition of a mental health condition called compulsive sexual behavior disorder (CSBD), which is a pretty big milestone in the mental health community.

“This is the first time internationally that there is a category for dysregulated or problematic sexual behavior,” Shane W. Kraus, Ph.D., director of the Behavioral Addictions Clinic at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass., and assistant professor of psychiatry at the University of Massachusetts Medical School, who was part of the WHO work group that developed the diagnostic criteria for CSBD, tells SELF.

CSBD is characterized by “a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour,” according to its diagnostic description in the ICD-11 this can include both the act of sex and sexual fantasies.

The umbrella term “impulse control disorder” includes a variety of psychiatric disorders “whose essential features are the failure to resist an impulse to perform an act that is harmful to the individual or to others,” according to the ICD. Individuals typically experience an increased sense of tension before the act, but then pleasure or gratification when they do the act, it goes on to explain.

According to the ICD, the hallmark symptoms of CSBD are “repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it.”

For example, someone with CSBD might be over and over again engaging in sexual behavior that they full well know is damaging their relationship with the person they love, like putting their impulse to have sex over their partner’s desires and other aspects of their relationship, or having sex with someone who is not their partner (assuming they’re in a monogamous relationship) in order to satisfy those strong and frequent urges, or engaging in this behavior to the detriment of their job or other responsibilities.

While the official diagnosis may be new, for many mental health professionals, the condition is something they see and discuss often. “A lot of the therapeutic community has been talking about this issue and working with patients seeking help for these kind of sexual problems long before it was canonized in the ICD-11,” Rory Reid, Ph.D., LCSW, assistant professor and research psychologist in the Department of Psychiatry and Biobehavioral Sciences at UCLA, tells SELF.

Reid compares the lag between clinical evidence of a problem and an official diagnosis to the trajectory of PTSD: The disorder was recognized by the APA in the DSM in 1980 after a wave of veterans sought professional help for their similar experiences. “We had all these military personnel coming back from the Vietnam War having these symptoms—flashbacks, anxiety—and they were going in to therapists and psychiatrists to talk about them,” he says. “So therapists started working with it long before it was canonized as a disease or a disorder, and then the scientific community caught up and said, ‘Yeah we're seeing this, too.’”

Having a lot of sex or sexual desire doesn’t mean you have a condition, similarly to, for instance, how not everyone who drinks what some might consider a lot has alcoholism. “[Their behavior] might cause distress or it might be an issue for them, but it doesn't mean they have a mental health problem,” Kraus explains.

The ICD criteria also cautions against conflating violating social or cultural norms with having a clinical condition. It explicitly states that “distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours” does not factor into a CSBD diagnosis. For instance, being into kink, having multiple sexual partners, or frequenting sex parties may not be everyone’s cup of tea but it doesn’t qualify you as having CSBD. “Compulsive sexual behavior, when properly diagnosed, is not in any way related to who or what it is that turns a person on,” certified sex addiction therapist (CSAT) Robert Weiss, author of Sex Addiction 101, host of the podcast Sex, Love, and Addiction 101, and CEO of Seeking Integrity, tells SELF.

“People have sexual behaviors that vary across people and cultures and groups, and we want to make sure we're not overpathologizing people based on specific values,” Kraus explains. The CSBD diagnostic criteria are based on science rather than conjecture, and “very specifically take morality and personal judgement out of the equation,” Weiss says.

In fact, the fear of overpathologizing sexual behavior based on what we view as normal, proper, moral, or socially acceptable is actually one of the controversies that led the American Psychiatric Association (APA) to reject the proposed addition of “hypersexual disorder” to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) back in 2013, Reid points out.

The APA objected that the diagnostic criteria for hypersexual disorder did not clearly differentiate between “normal range high levels of sexual desire and activity” and “pathological levels of sexual desire and activity,” according to a paper that Reid co-authored in 2014. This lack of clarity created a potential for “false positives,” the APA argued, “erroneously diagnosing an individual with a mental disorder that is a normal variant of human behavior.”

WHO’s addition of CSBD has stirred up this existing controversy on the subject of how to define and diagnose disorders related to sexual behavior. “There was never any dispute that healthcare professionals are seeing [the issue of CSBD] all over,” psychologist Eli Coleman, Ph.D., director of the Program in Human Sexuality at the University of Minnesota Medical School and founding editor of the International Journal of Sexual Health, tells SELF. “It’s just been a matter of debate about what we call it.”

The specific language that the medical community (and society in general) uses for a particular condition matters it shapes our conception of the condition, and in turn, determines how people dealing with those issues are perceived and the treatment they receive. In the case of psychiatric and behavioral disorders, the name experts settle on and the category they file it under (addiction, impulse control disorder, obsessive compulsive disorder) refers to the underlying brain mechanism, or how that particular disorder is thought to be working in the brain. That then tells us how to approach treatment and what treatments are most likely to be effective, Reid explains.

In regards to CSBD, the largest point of contention is whether or not the disorder should be categorized as an addiction. “There is ongoing scientific debate on whether or not the compulsive sexual behavior disorder constitutes the manifestation of a behavioral addiction,” WHO spokesperson Christian Lindmeier tells SELF. “WHO does not use the term sex addiction because we are not taking a position about whether it is physiologically an addiction or not.”

But unlike the phrase compulsive sexual behavior disorder, most people are familiar with the term sex addiction. It’s also long been used by the mental health professionals that counsel people with these issues.


Detachment: A Strategy for Friends and Family of Adult Addicts

For every adult who struggles with addiction, there are many affected by its destruction. Family, co-workers, and friends are among those who become witnesses to the downward spiral of self-destructive behavior. Attempts to fix a friend or loved one experiencing addiction become increasingly frustrating as the chaos becomes a part of daily life.

When you are affected by someone else&rsquos drinking or drug use, it is important to remember that even though you cannot prevent what&rsquos happening to them, you can regain your sanity by practicing detachment.

What is detachment?

Detachment is when you let other people experience their consequences instead of taking responsibility for them. This is a key component of the recovery process for family and friends of addicts. Redirecting focus away from an addict&rsquos negative behaviors can restore the balance of the relationship dynamics, as well as re-start self-care.

Of course, detachment doesn&rsquot mean that you stop caring. The popular phrase is &ldquoto detach with love&rdquo promotes loving the person, even when you don&rsquot approve of the behavior. Detaching means that you lovingly let go of solving the problems associated with the addiction.

When a person experiencing addiction misses work, neglects his or her responsibilities, or does something like crashing the car, let them handle it. This invites the addict to take responsibility for his or her own mistakes and take control of his or her own life.

The central premise of detachment is letting go of trying to fix the addict&rsquos life. This becomes especially difficult when the alcoholic chooses to do nothing because that refusal often triggers loved ones to rescue them.

However, by solving problems for the addict, you are preventing him or her from experiencing the pain associated with the addiction. Such pain is necessary in order for an addict to choose sobriety.

Family and friends of addicts often fear that the addict will end up incarcerated or dead. This fear is not unfounded sadly, many addicts continue using despite the consequences to their health and well-being. Therefore, that fear leads you back to rescuing them. However, rescuing addicts trigger a cycle of control that depletes family and friends to the point of emotional and physical exhaustion.

In Al-Anon, a 12-step program for friends and families of alcoholics, there is an important saying to help remind us of those necessary boundaries in relationships with addicts: &ldquoYou didn&rsquot cause it, you can&rsquot control it, and you can&rsquot cure it.&rdquo This phrase is helpful to consider in its parts:

You Didn&rsquot Cause It

Regardless of why the addiction started, you are not responsible for the behavior of a loved one experiencing addiction. You are only responsible for your own behaviors and your own actions.

You Can&rsquot Control It

Once a brain becomes dependent on a substance, rational decision-making is significantly impaired. This explains why an addict&rsquos behavior is no longer rational: they cannot see the impact that using has on their own behavior.

You Can&rsquot Cure It

An addict&rsquos brain gets hijacked by the dependency, which impacts his or her ability to think and make sound decisions. These physiological changes make it impossible for the addict to see what&rsquos happening to them.

To a non-addict, it may look like the addict can stop using. However, those who have never experienced addiction can&rsquot understand the physical allergy that creates the addictive response. This lack of control is the hallmark of addiction.

The Affects on the Family

Over time, living with active addiction creates anxiety, depression, and chronic stress for those closest to an addict. Many family members suffer in silence, while the addict doesn&rsquot see a problem. Children in particular act out and may become depressed or anxious.

The shame associated with addict&rsquos behavior prevents family members and friends from seeking help. As family members of addicts, you may isolate socially because it&rsquos embarrassing to witness the outbursts. You may stop talking to family and friends because you fear being judged.

Practicing good self-care becomes essential for restoring emotional and physical health of entire in the family. Dealing with active addiction creates a pattern of self-neglect that needs healing. Redirecting the focus back on what you need makes detachment possible because your energy is no longer spent solely on the addict.

How to Start Practicing Detachment

Detachment works best when you can detach with love. This means letting go of the anger and finding alternatives ways to handle the stress of living with an addict. Here are some beliefs that need to be addressed in order to detach:

  • Avoid making assumptions &mdash if you stop helping, something bad will not necessarily happen.
  • Challenge the belief that you have all the answers.
  • You are not responsible for an adult addict&rsquos problems.
  • It&rsquos okay for you to get your own support system.
  • Self-care isn&rsquot selfish, regardless of other well-meaning people say.

Detachment can transform the entire family dynamic. Practicing these behaviors will indirectly benefit the addict because he gets an opportunity to face the truth about his own behavior. Detaching also restores the family&rsquos equilibrium since the attention is no longer focused solely on the addict.

  • Not make excuses for an addict&rsquos behavior
  • Stop handling an addict&rsquos problems
  • Avoid becoming a passenger while he or she is intoxicated
  • Leave a situation before an addict becomes abusive
  • Stop responding to an addict&rsquos attempts to blame and
  • Accept that you are powerless over the addict&rsquos behavior.

Simple Detaching Behaviors That Work

  • When confronted with verbal attacks, silence works. If you need to, leave the room.
  • Recognize that rescuing doesn&rsquot help the addict long-term.
  • Take care of YOURSELF instead of trying to fix them.
  • Refrain from giving advice or preventing their use.
  • Keep children safe by minimizing their exposure.

Finding Additional Support

When considering options, recovery may include inpatient or outpatient treatment, individual and family counseling, and 12-step programs like Alcoholics Anonymous and Al-Anon.

Families often seek help before the addict does because watching the addict self-destruct becomes too painful. In recovery, the family learns not to force treatment but instead give the addict the dignity to decide on his own. Hiring a professional interventionist provides a more structured approach when the addict is out of control.

In particular, consider Al-Anon , a free support group for families and friends of those who are struggling with addiction. They also have groups for children affected by the disease. If you are not comfortable in groups, try some individual or family counseling for a more private place to heal.

Detaching is not easy but it does preserve the relationship without participating in the addict&rsquos disease. It separates the person from the addiction. Keep in mind that any addict has a disease much like mental illness. The addict cannot control their behavior, though they are responsible for their choices. Starting the process of growth and recovery is a delicate balance of loving the addict without attempting to rescue them.

It is very important that friends and family of addicts focus on taking care of themselves. To engage in self-care is difficult and takes practice but ultimately, there is no lasting relief without it.


Watch the video: ΖΗΤΗΣΕ ΤΟ ΚΑΙ ΘΑ ΣΟΥ ΔΟΘΕΙmanos latriasΔειτε το κ εφαρμοστε το (January 2022).