Compulsions / Addictions

In daily life we often hear casual remarks like, “It’s just addictive!” or, “I could get addicted to that!” It’s likely that the authors of such comments intend primarily to convey just how pleasurable or worthy of repetition a certain experience has been, whether it’s tasting a new ice cream flavor or experiencing a fun activity. Yet, such common, offhand utterances may also produce a slightly anxious sensation in the speaker; the evocation of addiction may even bring on a vague, passing recognition that one could somehow lose the capacity to choose to partake or not.

Thus, all things that attract us, and which promise and sometimes deliver pleasure, may also threaten to touch a strand of vulnerability which is woven into us all: It is that our initial gratification in harmless pleasurable experience may also contain the basis for its transformation into a power operating beyond the reach of choice. When such a condition fully emerges it is called addiction: Its gradually intensifying, insidious operations can greatly limit the range of options available to our way of feeling and thinking, and can redirect and rigidly dictate the trajectory of our behaviors. Addiction’s ultimate potential impact is to dominate and define the very course of our lives.

The Role of Compulsion

Key to understanding the potentially fateful transformation which is the onset of addiction is the concept that any pleasurable experience can and often does serve, simultaneously, as a respite from discomfort and pain. Indeed, any individual’s psyche can recognize that a certain rewarding behavior or activity (even a pleasant sequence of thoughts or a fantasy) can also act to suppress or displace uncomfortable and unwanted feelings, primarily those of vulnerability, shame, and the anxiety that accompanies them. It is at this point that a person may become unconsciously and repeatedly, that is, compulsively directed toward that behavior, whether it continues to be pleasurable and rewarding or not.

At such a dynamic tipping point an individual’s psyche has come to respond primarily to some learned, default strategy for diminishing or displacing negative feelings. Thereby, that person automatically returns to what has become an ever-more familiar, internalized pattern. This can and often does occur despite the absence of the original pleasure and reward, the behavior persisting without conscious consideration of punishing consequences to the self, and often, others as well.

In my general understanding and clinical approach to addiction, the dynamics of compulsion function at its very center. In this, I observe that the more emotional discomfort (particularly anxiety) that an individual carries within, and the less his/her capacity to recognize such disturbance (perhaps disowned over time and even reinforced by cultural norms and demands), the more vulnerable that individual will be to compulsion, possibly leading to stark addiction.

I often and freely express my view that all aspects of one’s life, including those which are most psychologically challenging and intense in their personal and social impact, nonetheless remain an integral part of a broad common ground of the human condition. So it is that compulsive dynamics can and do operate to some degree within all of our lives, as we daily, frequently, do certain (usually innocuous) things, or think about ourselves in certain enhanced ways, primarily in order to avoid feelings which we would rather not have. Thereby, some component of compulsion is quite naturally present and woven throughout the complex matrix of human motivation; it is fully manifest in all things that we do in order to reduce or eliminate negative and uncomfortable feeling states.

In my view, compulsion is a prime example of how a basic, universal psychological phenomenon, widely reflected to some degree throughout human experience, is not so far removed, except by degrees of intensity, from the most troubling and sometimes critical occurrences in society. Nonetheless, we tend to recognize the omnipresence of compulsion nearly exclusively at the more intense points along its continuum, mainly in stark addiction, and primarily in those personally and socially destructive behaviors of others which cannot easily escape our attention.

Today the media, and perhaps our daily lives, frequently present us with stories of persons driven (compelled) to certain desperate actions, or to extreme behaviors which seem to have had a life force of their own. These are often accompanied by widespread, public expressions of astonishment and even bafflement, and much deep, well-intentioned soul-searching as well. In such circumstances, but far less frequently, we may come to recognize, even for a fleeting moment, some thread of basic communality between our own ways of managing and extinguishing our own most uncomfortable emotional experiences and those of the protagonists of extreme acts and shocking headlines.

Yet, I observe that while we all participate in compulsive behaviors, to some degree and at some level, we simultaneously, quite naturally, tend to exempt ourselves even from awareness of our present or potential vulnerability to its most serious dilemmas and negative consequences. Ironically, this perceptual “blind spot” often creates and supports a heightened potential for compulsion and addiction to take root within our lives and to skew its direction. The dynamics of such self-exemption help to explain how painful, truly consequential conditions such as compulsive overeating or food restriction, hoarding, compulsive gambling, alcoholism and drug addiction often baffle even the most informed, close-by observers.

They may largely account for how these most serious and impactful conditions can often be “normalized” while fully present within a given family or social milieu, remaining unrecognized, unnamed, and unaddressed as such. The phenomenon of non-recognition can be sustained as much by the primary sufferer as others in his/her sphere. Above all, in many such instances, perceptual blindness to compulsion and addiction- commonly termed “denial” – can be of one’s own making, and in relation to oneself.

I know and understand compulsions and addictions, and I treat individuals at all levels of these most challenging and potentially tragic human conditions.

I help persons who still struggle within compulsion/addiction-driven lives, perhaps unable to acknowledge its presence as such;

I help those contending with persistent compulsions related to acknowledged addiction, and those dealing with addiction’s complex repercussions;

I help those among the many who have been touched by living experience in Recovery: persons whose addiction has been transformed within its unique and rewarding pathways, and who seek to deepen their connection to themselves and others.

If you recognize any aspect of yourself among these persons and are seeking further help, please feel free to contact me.

My Perspective of Recovery

As a mental health practitioner with years of experience treating clients with histories of addiction and compulsive conditions, I witness the therapeutic, often deeply transformative power of the recovery experience as an undeniable living reality. Recovery, often collectively described as “The Recovery Movement” or “The 12-Step Culture,” may be specifically identified by any of the component programs of its broad sphere: Alcoholics Anonymous, Al-anon, Narcotics Anonymous, Overeaters Anonymous, Debtors Anonymous, and a host of closely-related fellowships. However identified, programs of recovery have proven a virtually indispensable resource for persons seeking to create and sustain a lasting remission from alcoholism and other addictions, and for those seeking lifelong manageability of deep compulsions.

The recovery movement as a whole – though highly regarded and widely revered by its participants- has also been a recurring target of broad misperception, mislabeling and sometimes, harsh criticism by a media and public generally self-excluded from any personal living experience of the Programs. Particularly for members of our society with little direct contact with addicts whose lives have been transformed by participation in a recovery program, their lifelong dedication to its culture and worldview can seem alien. This skepticism is naturally underscored by certain valued principles central to the Recovery culture itself, among them: emphasis on attracting participants over direct advocacy and promotion, and the clear recommendation that its members maintain their “anonymity” in public. This central anonymity principle serves to safeguard both the fact of an individual’s being in recovery from addiction/compulsion, and that of his/her association to any particular recovery fellowship.

Furthermore, for reasons partly related to these guiding principles, rigorous statistical evaluation of the long-term efficacy of 12-step recovery has been historically impossible.

Yet, despite even significant anecdotal evidence of addiction relapse within the ranks of the recovery fellowships; despite the continuing and natural psycho-social struggles of many of the individuals who do maintain long-term abstinence from addictions and compulsive behaviors, certain truths prevail, and they are unambiguous:

For centuries, addiction, and alcoholism in particular, represented an irreversible one-way path in the lives of those afflicted. These conditions, dreaded and widely reviled, generally led to years of unrealized potential and unfulfilled living; they inflicted physical misery and created immeasurable emotional turmoil in the lives of the afflicted as well as the persons whose lives they impacted. Until a major turning point in the 1930’s, marked by the founding of Alcoholics Anonymous, the almost inevitable trajectory of an addict/alcoholic’s life was precipitous physical and psychological decline, often leading to premature death.

The almost eight decades of AA and its related Recovery programs have created an unprecedented alternative course by which millions of previously doomed persons have been directed out of chronic suffering, away from self-defeating and abusive behaviors, and often, toward transformative self-realization over the course of entire lifetimes.

A client’s participation in recovery in one or more of the Recovery fellowships is therefore a welcome element in my work as a psychotherapist. It can provide needed day in and day out therapeutic experience and social support along lines fully compatible with my clinical perspective and approach. An individual’s participation in recovery is not only wholly synergistic with their work with me in therapy (the total being greater than the sum of the parts): It is a nearly-indispensable element in achieving and sustaining positive changes in the lives of those with significant histories of compulsive behaviors and addictions.