How to understand addiction

Based on a Gestalt Therapy workshop

I took part in this workshop to help me better understand the behaviours of smokers, to support the stop-smoking program I was building with Mindset Health.

What I learnt is that addiction is everywhere.

It’s any behaviour we repeat despite adverse consequences.

Hello social media, overworking, procrastinating…

That’s why understanding the process behind addiction is so important.

And that’s why I’m sharing the key learnings here 😊

What is addiction?

• any behavioural pattern associated with cravings, which offers temporary relief, but the person is unable to control it despite awareness of negative consequences
• compulsive self-soothing behaviour that is our best attempt at achieving homeostasis (i.e. it’s a substitute for healthy self- or co-regulation and connection to self and others)
• our best attempt to manage and regulate emotional pain and nervous system dis-regulation and meet our core needs
• often an adaptive behaviour in the context of maladaptive environments (e.g. poverty, marginalisation, trauma, neglect…)

Common themes of people with addiction

• often lacking self-regulation of nervous system
  • have an impulse to self-soothe when triggered
• believe that what they feel ‘is not OK’
  • the next moment promises what this moment doesn’t have
• often do not have the language to identify and name emotions
  • when you name a feeling, you can tame it
  • in order to manage pain, people with addictions have often disconnected from their body
• needs that addiction are meeting at core level = avoiding pain / seeking pleasure
  • numbing, connection, belonging, boredom, comfort, security, confidence, purpose
  • whenever you recognise the need, you realise it’s just a human need
  • addiction is just a misguided attempt to meet a need
    • “looking for the right thing in the wrong place”
• people will quit when the pain of staying the same becomes bigger than the pain of change

Behaviours of clients with addictions

• looking for a quick fix
• want to be saved and rescued → sets up for disappointment
• clients will relapse 5-10 times with a therapist
• a lot of ambivalence → one week keen, then the next not
• “tried that, it didn’t work for me”

Why do people with addictions relapse or not seek support

• fear of the unfamiliar
  • “better the uncertainty of misery than the misery of uncertainty”
  • feel at home in the addiction
  • fear story = what we anticipate is often worse than reality (e.g. fear of cravings)
• start to feel good
  • “if I start to feel good, something bad is going to take it away” → I’m not in control
• rush to healing
  • perpetuates self-rejection (too much pressure on themselves)
  • need to educate to be patient on the change process
• paradox of change
  • the more the therapist pushes for change, the more the client digs their heals in
• self-sabotage
  • when they start to turn a corner, they find it too confronting or feel they don’t deserve it
  • not feeling worthy, self-esteem issues, self-loathing
• grief at letting go of addiction

How to overcome addiction

• learn to appreciate the positive intention of the inner critic (compassionate understanding) and set boundaries (e.g. allow to voice but not act)
• look for a pathway towards wholeness/integration rather than perfection
• recovery is synonymous with recovering our ‘self’
  • move from disconnection to connection
  • move from disregulation to regulation
  • move from self-rejection to self-compassion
  • meaningless to purpose and meaningful contribution

Cravings

• “Between the stimulus and a response is a gap, and in that gap lies our power and our freedom.” - Victor Frankl
  • there is a gap between a trigger and the action that we can broaden
• “You cant stop the waves but you can learn to surf them! We cant will away our addictions, but we can be willing to pause and pay attention to the craving and relate to it in a different way?” - Tara Brach

PACED - A craving regulation skill

• Pause and stop – find a place to sit and come into the moment.
• Acknowledge- your experience – 3 mins or more if required.
  • Name and notice - What am I feeling? What thoughts or beliefs am I having? What images are popping into my mind relate to cravings?
  • What sensations am I feeling in my body. I am having the thought that….; I am having the feeling that…; I am having the sensation that….
• Connect – to your body and the earth – 3 mins
  • To your legs on the ground, To your sit bones on the chair.
  • To a place in your body that feels settled
  • To your outbreath
  • Engage – 3 mins
  • Your senses – 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, 1 thing you can taste
• Distract – Re-focus your attention on something that gives you meaning or healthy pleasure.

Ideas

• addiction is all about self-soothing the nervous system
• an important part of therapy is starting with a joint contract, focused on intentions and values (e.g. motivations for quitting)
• addiction is actually hugely common (it’s more of a spectrum and can cover anything from shopping, scrolling, self-improvement). we need to normalise addiction (reframe as ‘creative adjustment’) so that people feel supported and not ‘othered’ which cause a shame spiral
  • at the core of an addiction is an unmet need. often people with addictions never learnt to regulate their emotional pain correctly and are seeking base needs such as connection, security etc.
  • e.g. we can remind people that they are “looking for the right thing in the wrong place”
• cravings are part of the process and may never completely disappear, but we can increase the gap between trigger and behaviour
  • we can use new language to talk about cravings e.g. “You cant stop the waves but you can learn to surf them”
• questioning is a big part of the therapeutic process:
  • what need does smoking fulfil? (e.g. identity, agency)
  • where will you be in 5 years if you don’t change?
  • what are the advantages of smoking for you?
  • what gets in the way of making the change you want? is there any part you could change?
• integration at the end of any healthy need satisfaction is essential (i.e. taking the time to note satisfaction and experience). very often people with addictions ignore this stage (e.g. chain smoking, another craving).
• there’s loads of new areas to understand to overcome addiction, e.g.:
  • investigating and dis-identifying the identities, beliefs and shame that maintain the addiction
  • fostering connection - finding a recovery community
  • identify reasons/motivations/values that support change and fears/inhibitions/beliefs about change