Addictions
Addictions
Addiction is one of the most controversial terms in the diagnostic literature. It is defined very differently by various professions and from different theoretical orientations within the same field. Alcohol, cocaine, heroin, nicotine, barbiturates, benzodiazepines, and many other substances are considered addictive. A wide variety of behaviors or activities have also been labeled as addictive. Examples include gambling addiction, compulsive shopping (aka retail therapy), binge eating, overeating, compulsive internet use, pornography addiction, sex addiction, or even exercise. However, these do not adhere to the standards some use to define addiction. Some experts that address these issues may even prefer terms of compulsions or abuse, which complicates matter.
Addiction is any behavior (which could be the ingestion of a substance), which is highly reinforcing (i.e., extremely pleasurable and/or removes aversive states, such as anxiety, worries, self-criticism, or physical pain) to the point that once the individual realizes it is ultimately self-destructive, but, seemingly cannot stop, despite having the “will”. Although addictive behaviors can be harmful in a small amount, most become more problematic if the frequency or intensity becomes extreme.
The 12-Step Program
- “We admitted that we were powerless over our addiction, that our lives had become unmanageable.”
- “We came to believe that a power greater than us could that restore us to sanity.”
- “We made a decision to turn our will and our lives over to the care of [the higher power] of our understanding.”
- “We made a searching and fearless moral inventory of us.”
- “We admitted to god, to ourselves and to another human being the exact nature of our wrongs.”
- “We were entirely ready to have god remove all these defects of character.”
- “We humbly ask [our higher power] to remove our shortcomings.”
- “We made a list of all persons we had harmed, and became willing to make amends to them all.”
- “We made direct amends to such people wherever possible, except when to do so would injure them or others.”
- “We continued to take personal inventory and when we were wrong promptly admitted it.”
- “We sought through prayer and meditation to improve our conscious contact with [our higher power] as we understand it, praying only for knowledge of its will for us and the power to carry that out.”
- “Having had a spiritual awakening as a result of these steps, we tried to carry this message to other addicts and to practice these principles in all our affairs.”
Self-Management and Recovery Training (SMART Recovery)
The Science of SMART Recovery
SMART is a scientifically supported abstinence based approach to addictive behaviors. It is based on four core points, which help individuals refrain from self-defeating addictive behaviors.
Four SMART Recovery Points
Point 1 – Enhanceing and Maintaining Motivation
Motivation is cultivated by identifying and clarifying values and making salient the negative consequences of alcohol and drug abuse.
Point 2 – Coping with Cravings and Urges to Drink or Use
Cravings and urges are treated as Activating Events that can be viewed as tolerable and temporary, even if they are highly aversive.
Point 3 – Problem Solving and Emotional Management
Rational-Emotive Behavioral Therapy (REBT) tools are taught to help SMART participants challenge irrational beliefs, identify and reinforce rational beliefs to help modulate intense emotional arousal.
Point 4 – Lifestyle Balance or Long-term Cost-Benefit Analysis
Hedonic Calculus (short-term and long-term cost benefit analysis) is utilized in order to counteract the heavy weight given to the short-term relief that alcohol and drug abuse exploit.
