Compulsion, Obsession, Addiction or All the Above?

Are repeated behaviors an addiction?   It would appear that it all depends upon what society and the experts consider addiction to be.  If the behavior is seen as one who repeatedly flips light switches, or washing hands several times, hoarding, or unlocking and locking a door several times, avoiding cracks in sidewalks as in the film, “As Good As It Gets;” tapping the tops of parking meters when walking down the sidewalk as depicted the TV series, “Monk,” they would call it “obsessive compulsive behavior.”  They would even call these behaviors the behaviors of a mentally ill person.  But if the behavior happens to be anything that involves sex, food, gambling, spending, alcohol, or drugs, it is called an “addiction.” And these, too, would be considered mental illness.

While there is no pathology to any of these so-called mental illnesses or diseases, they do have one common denominator:  Those who display these behaviors are emotionally distressed.   And underneath all of their unhappiness is an unsatisfying relationship(s) with someone of whom they would like to have a better relationship.  When all known methods a person has to ease their unhappiness fail to afford them the relief they desire, the human mind can become very creative.  Any behavior an unhappy person discovers that eases their frustration, even in the least amount, becomes the method that is relied upon to make their emotional distress tolerable.   And since it is only a temporary measure of relief, it must be conducted often to be effective.

Behaviors that involve food and sex are, perhaps, the most difficult to control inasmuch as we need food to sustain life and the drive for sex is genetically hard-wired in us.  Sex is used for marketing everything from weight loss programs to automobiles.  Added to that is all of the porn that is available on the Internet and television ads declaring that if you aren’t having or performing satisfying sex, then you can retrieve the “best part of life” through the wonders of the pharmaceutical companies.  If sex is the best part of one’s life, then one’s life is not very fulfilling in the first place, with or without sex.  And herein lies the crux of the matter:  The difference between happiness and pleasure . . . both of which are oft referred to as addictive or compulsive behaviors.

Gambling, spending, sex (with or without a partner), drinking alcohol, using drugs, working long hours, binge eating, hoarding, huffing,  and obsessive and compulsive behaviors can all be performed without the involvement of another person.  These pleasurable behaviors are much more physically and emotionally intense than those of happiness and result in a rush of the neurotransmitter dopamine in a part of the brain called the Nucleus Accumbens.  But these neurotransmitters dissipate rather quickly, necessitating repetition of the behavior to experience the pleasurable effect.

Happiness requires meaningful relationships.  Sex for the sake of self satisfaction, with little to no meaningful relationship involved, is only a pleasure-satisfying behavior and selfish at best.   Yet the need to satisfy the genetic sexual urge, if severely lacking in one’s life, often leads to choosing the wrong partner in marriage.  Watching a movie this morning, a scene involved a couple who just met and quickly became sexually involved instigated by the woman.  When the act was over, she was satisfied and had no meaningful connection with the man.  He, having apparently not been sexually satisfied in months or years stated, “I love you.”  Her selfish needs were met without intimate connecting while he perceived his pleasurable experience as happiness and declared his love for her while having met her less than an hour ago.  He will “fall in love” with anyone with whom he has a sexual experience.  Hence the song lyrics sung by Frank Sinatra and Chet Backer, “I fall in love too easily. I fall in love too fast.  I fall in love too terribly hard for love to ever last.”  Both Frank and Chet had a history of troubled relationships.

Conversely, when a person chooses to get their sexual needs met with no intent or desire to have a meaningful relationship, they are only satisfying their basic genetic biological urge but not the corresponding genetic need for love and belonging.  While the biological urge is satisfied causing pleasure, the genetic need that creates happiness does not get met.

A client of mine in his late sixties became a widower.  When he met his wife, he had a history of womanizing.  She had a history of compulsive gambling.  Of all of the women he had known, she was the only one who came close to satisfying his genetic need for a meaningful relationship.  He was the missing factor in her life that gave her reason to not need to gamble to satisfy her need for pleasure.  She found happiness in him and he with her.  With a bit of effort to change long term self-satisfying behaviors, they were both able to forego their compulsive behaviors of short-lived pleasures for the sake of long term marriage and happiness.

But when she died, he reverted back to his old ways.  He was devastated over the loss of his wife.  She was the one who kept him in check.  His life had meaning and success with her in his life.  Pleasure seeking is the most common ways in which people attempt to overcome their unhappiness.   This is what leads to alcohol and drug abuse, compulsive sex, eating disorders, gambling, spending, and all other compulsive behaviors.

My client began to obsess about the conquest of women many years younger than he to satisfy his sexual needs and to meet his need for power . . . the need for respect, appreciation, worth, and acceptance . . . the things he had when married.  After his wife’s death,  he saw women as a challenge to win over in a way that would lead them to giving into his charming ways.   Once any of them might show a desire to become involved in a meaningful relationship, he would abruptly end the one sided relationship.  He proudly referred to his behavior as “Catch and release.”  He spent hundreds of thousands of dollars on material items in an effort to acquire happiness and draw attention to him from women that, at best, only offered short term pleasure.  

Trying to fill the void in his life from his wife’s death, as well as perceiving pleasure as happiness, was his purpose.  He maintains the image of his deceased wife in his Quality World as the only woman who could have ever given him what he wanted and needed and no one else can ever do that as well as she did.  Therefore, he doesn’t even expect to find anyone who can replace her.   After years of spending all his money, owing back taxes, the risk of losing his home, and not ever having a meaningful relationship, he found that nothing was working to give him meaning and happiness in life.  While not one who would purposely end his life, he had a deeply pessimistic view of life and often stated that he was only biding his time before he “checks out.”  What he wants and needs in order to be happy is actually being sabotaged by his image of himself in his Quality World.

In his Quality World, his self image is totally different than what he says he “should” be.  He reports he should be:  A caring father, a responsible citizen, a Christian man who gives back to the community.  But “I just can’t see it.”  It isn’t that he can’t see it.  It’s that he doesn’t want to see it as evidenced by his further remarks of, “I don’t want to be that person.  It just ain’t me.”  Instead, he visualizes himself as a successful owner of many luxury items, a person who attracts women, and people who admire him and want to be like him; a person who makes things happen and can influence people with his charm.

The only thing that will turn his life around from unhappiness to happiness is to replace his Quality World image of himself; stop his self-defeating behaviors, and seek a meaningful, trusting, intimate, caring relationship that he had with his wife and to see himself as an individual who has more to offer than someone whose worth is measured by material possessions that only serve as bait to impress others and catch women.  His neediness is so self-serving that he fails to see just how selfish and uncaring of others he is.  Is he mentally ill?  No.  Is he addicted to sex?  No.  He is choosing obsessive and compulsive behaviors in an attempt to provide some modicum of pleasure (which he perceives as happiness) and it isn’t working consistently enough to be satisfying.  He is working hard at living up to an image of being someone he would like to be rather than who he really is.  He is fighting against his innate personality and losing the fight.  This fight has been ongoing for many years, save those in which he was married.  The old drives were still there but not to the point that he acted on them in his marriage.

When we hear that one is addicted to sex, work, indiscriminate spending, gambling, eating, and hoarding, these behaviors are no different than the person who repeats unnatural behaviors that are called Obsessive/Compulsive.  And like Obsessive Compulsive behaviors, there are no laboratory tests that are indicative of an illness or disease.  These behaviors are merely the behaviors of emotionally distressed individuals whose chosen behaviors are their best attempt, at the time, to ease their unhappiness.

Of all of the compulsive behaviors, only two of them have a biocellular altering effect:  Alcohol and drugs.   When addictive substances are continually introduced into the body, the body must learn to adjust to their presence.  The cells restructure to function with the substance in the body’s system.   Gambling, spending, sexing and sexting, long work hours, flipping light switches, locking and unlocking doors, washing hands 3 to 5  times before stopping, avoiding cracks in sidewalks, tapping the tops of parking meters, etc.  do not culminate in cellular restructuring. 

People don’t start drinking or using drugs because of addiction.  They drink and use because they feel better when drinking and using than when they are not drinking or using.  They drink and use because they like how it makes them feel . . .  no different than chosen obsessive/compulsive behaviors.  But the continued use of drugs and alcohol will eventually cause the body’s cells to become dependent upon them in order to feel better both physically and emotionally.  And that becomes the addiction.  None of the other listed obsessive compulsive behaviors have this physical effect; have no physical withdrawal symptoms when ceased as with drugs and alcohol, and are therefore not addictions.  They are chosen behaviors to feel emotionally better and serve to take their mind off of things they don’t want to think about that would make them feel bad.

Regardless, whether they be obsessive, compulsive, or addictive behaviors, the behaviors are frequently repeated for the same purpose . . . to ease emotional distress.

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