How to Heal From Emotionally Unavailable Parents

How to Heal From Emotionally Unavailable Parents

If you’ve grown up feeling like something was missing, you may have been emotionally neglected. You may not identify as being neglected if your physical needs were met, but the lack of emotional support left you emotionally isolated.

You may have felt invisible, dismissed, or unaccepted the way you are. This is a commonly overlooked experience among children of emotionally unavailable parents. These children grow up suffering in silence, feeling empty but not necessarily knowing what’s wrong, often blaming themselves.

Being told they are too sensitive, these children often feel dismissed and rejected, learning to avoid going to their emotionally unavailable parents for support.

They learn their parents are a source of stress rather than support. They can be unpredictable, unreliable, or too self-involved to attend to the child’s emotional needs.

From an early age, these children may take on adult responsibilities or find themselves parenting their parents. As they grow up, this behavior can lead to self-neglect by constantly putting others first.

Finding themselves repeatedly involved in lopsided relationships, doing all of the emotional labor, with people who exploit their generous nature, the fantasy of emotional connection is withheld like the ever-elusive carrot on a stick.

“If I do more, maybe I’ll finally be enough, and they will meet my emotional needs,” you may tell yourself, as you run on the endless treadmill of others’ demands.

The starved need to be needed results in constant emotional repression, masking your true nature. Toxic shame leads to lowering personal boundaries and resentment of others who constantly cross them. This repressed anger is concealed by a mask of cheeriness and determination.

If you or someone you know is burnt out and looking to heal from the distress instilled by emotionally unavailable parents, there is a way out.

I recently discovered the following book, which gives powerful insights and practical tips on how to recover from this exact issue:

Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents by Lindsay C. Gibson PsyD.

It has quickly become one of my favorite psychology books. Immediately after reading it, I was compelled to reread it and summarize the insights.

As a counselor, I talk to a wide range of people, and this has been one of the most common invisible injuries. Since I couldn’t find a good summary of this book, I thought I would create one.

If you’re interested in reading the full book but can’t find the time, you can check out the audiobook version I linked above and listen to it while you’re driving or doing household work.

Otherwise, enjoy the summary!

What is Emotional Immaturity? 

Throughout the book, Lindsay C. Gibson PsyD demonstrates how emotional immaturity among parents leads to emotional neglect among children. She proposes several traits associated with emotional immaturity, which can be summarized as the following:

Emotional Immaturity is characterized by a fear of emotional involvement resulting in emotional distance, emotional instability, psychological inflexibility, and self-centeredness.

Emotional distance often presents as holding back from emotional closeness, fear of emotional involvement, and lacking the ability to provide emotional support to persons in need of genuine connection.

Emotional Instability presents as unpredictable emotional states and unreliability. A person may fluctuate between anger, engagement, and coldness, keeping others walking on eggshells.

Psychological Inflexibility presents as having rigid beliefs. Rather than dealing with reality, a person relies on coping mechanisms that resist reality.

Self-centeredness presents as blindness to the needs of others, using others, boundary issues, and emotional manipulation. At the extreme end, there may be diagnosable narcissism or sociopathy.

Emotional Immaturity Test

In her self-assessment tool, Lindsay C. Gibson PsyD lists the traits of emotionally immature parents, which I organized into four clusters for ease of use.

She states that you may be dealing with an emotionally immature parent if you can check off more than one of the following statements.

Emotional Distance

  • My parent didn’t express much empathy or emotional awareness.
  • When it came to emotional closeness and feelings, my parent seemed uncomfortable and didn’t go there.
  • I didn’t get much attention or sympathy from my parent, except maybe when I was really sick.

Emotional instability

  • My parent often overreacted to relatively minor things.
  • My parent was inconsistent—sometimes wise, sometimes unreasonable.
  • If I became upset, my parent either said something superficial and unhelpful or got angry and sarcastic.

Psychological Inflexibility

  • My parent was often irritated by individual differences or different points of view.
  • Even polite disagreement could make my parent very defensive.
  • Facts and logic were no match for my parent’s opinions.
  • My parent wasn’t self-reflective and rarely looked at his or her role in a problem.
  • My parent tended to be a black-and-white thinker, and unreceptive to new ideas.

Self-centeredness

  • When I was growing up, my parent used me as a confidant but wasn’t a confidant for me.
  • My parent often said and did things without thinking about people’s feelings.
  • Conversations mostly centered on my parent’s interests.
  • It was deflating to tell my parent about my successes because it didn’t seem to matter.

Types of Emotionally Immature Parents

Emotional immaturity tends to manifest as four general types:

  • The emotional parent 
  • The driven parent
  • The passive parent
  • The rejecting parent

One or both of your parents may fall into one of these general categories. Let’s take a deeper look at what each of these types entails.

The emotional parent instills feelings of instability, producing nervousness and anxiety for all those who have to walk on eggshells. They have “stormy emotional weather,” and you never know the forecast.

Intoxication amplifies the instability, perhaps leading to intimidation. These individuals are easily thrown off their emotional balance by mild distress and are primarily governed by emotional impulsivity.

The driven parent stays busy trying to make everything and everyone perfect. They appear to be quite normal and well-adjusted, but under the surface, they show their emotional immaturity by believing they have all the answers and they know what others what.

They appear supportive of your success but make assumptions about your desires, often pushing things on you. Their driven support comes from their own need to live up to high internal standards rooted in their own emotionally deprived upbringing. They may fear embarrassment if you underperform, leading to you feeling constantly evaluated in school or hobbies.

Driven parents are always keeping busy and worrying about getting things done. This added pressure makes you feel like you should always be doing more or doing something other than what you are currently doing. This can lead to thoughts of not being enough or insecurity regarding evaluation.

Driven parents often cross personal boundaries. Making assumptions or invalidating your interests, they often do things for you without asking for permission and become overly involved in your life, extinguishing a sense of independence.

The passive parent avoids dealing with anything upsetting. They can be easygoing, playful, affectionate, and often in good spirits but fail to protect their children when they need it emotionally.

If a passive parent gives you affection, it often comes from a self-centered place of using you to feel loved or needed, meeting their own emotional needs. Without recognizing this, you may naturally gravitate to the attention given by this parent, perhaps thinking of them as the “favorite parent.” Despite potential positive experiences, you may feel like this parent is not there in an essential way.

Passive parents turn a blind eye to abuse or neglect, retreating when times are tough. They may even leave the family if they get a chance at a better life, leaving their children feeling deeply rejected.

The rejecting parent is withdrawn, dismissive, and derogatory. They openly reject attention from their children, appearing irritated and dismissive of children in general.

They constantly have a wall around them, lack empathy, and can appear menacing and aloof. At the extreme end, they may have sociopathic tendencies and are capable of physical attack.

If you have a rejecting parent, you may find it hard to ask for what you need, resulting in an avoidant attachment style.

The Two Reactions to Emotional Immaturity 

Children of emotionally immature parents commonly react in two general ways, depending on the child’s temperament:

  • Externalizing 
  • Internalizing 

Externalizers have an external locus of control when things go wrong, whereas internalizers have an internal locus of control. In simple terms, externalizers blame others, and internalizers blame themselves.

Although you may generally fall into one of the two categories, there may be mixed reactions since it is a spectrum rather than a binary.

Let’s take a closer look at what each of these reactions entails.

Externalizing

Externalizers blame others when things go wrong. They may act out, and people generally label these children as having behavioral problems. This may involve substance use, reckless behavior, or rebellion.

These children may also take on characteristics similar to emotional immaturity. Growing up, they force their needs on others, using emotional manipulation such as guilt and blame.

Externalizers present as having a visible issue, and their struggles are not easily overlooked, causing others to recommend treatment. Although they are the most likely to be confronted by others to seek treatment, they are often the least likely to get support because they tend to externalize blame.

Internalizing

Internalizers look within themselves for why things go wrong. They are highly sensitive and attuned to their environment, keeping strong emotions bottled inside. Wearing a mask when engaging with others, they fear truly opening up and being genuine because they believe their very nature is a problem.

Internalizers have a deep need for connection and feel painfully lonely, constantly seeking genuine emotional connection. They believe the best way to find connection is to become a likable person, putting others first, constantly over-extending themselves for others. Self-neglect is seen as the cost of connection.

Fueled by the thought of “not being enough,” internalizers seek to make up this lack of “being” through constant “doing.” They believe their value depends on how much they do, not who they are. The fantasy of winning the affection of others keeps them on this treadmill of self-neglect.

Unable to say “no,” internalizers do most of the emotional work in relationships, often feeling resentful of those for whom they have taken responsibility. Instead of expressing their anger, they wear a mask of cheeriness or a determined can-do attitude.

Since emotionally immature parents rejected their feelings, they internalize the voice of rejection, taking a rejecting attitude toward their own feelings. They downplay their suffering, often apologizing for their emotions. Feeling guilty for taking other people’s time, they feel like a burden when asking for help.

Internalizers may also internalize the voice of judgment. Harshly criticizing themselves, they remain closed off to sharing their needs or struggles, fearing judgment by others for being inadequate. This leads to feeling further isolation and embarrassment if requiring support.

If an an internalizer’s emotions are taken seriously, they are often suppressed since they are used to “getting by on vapors” regarding affection from others.

Unlike externalizers, internalizers can go unnoticed. They are often high-performing and focused on achievement. Therefore, an emotionally immature parent may see them as having no needs. If an internalizer has an externalizer sibling, this may also cause jealousy or criticism from the externalizer, due to the social comparison.

Internalizers focus a great deal of their energy on fixing and rescuing others. The greater the difficulty, the more they try. The more they try, the greater the difficulty. This spiraling effort is often spent trying to change people who don’t want to change themselves, leading to burnout and resentment.

Healing from Emotionally Immature Parents

You were not born to fix your parents’ unhealed trauma.

From @selfhealth3

Healing from emotionally immature parents requires discovering your healing fantasy, stepping out of your role self, clarifying your values, setting personal boundaries, taking an observational perspective, and engaging in self-care. 

The healing process may take time since old habits are deeply engrained, but there are things you can start doing today to begin the process.

Discover Your Healing Fantasy

Throughout the book, Lindsay C. Gibson PsyD uses the concept of the “healing fantasy” to describe an internalizer’s attempt to win the affection of their emotionally immature parent.

The healing fantasy generally consists of thoughts that perhaps they will change if only you can do more. This can lead to the ineffective helping behaviors described above, overachievement, perfectionism, or falling into old patterns in relationships with romantic partners.

The first step to healing from an emotionally immature parent requires identifying your healing fantasy.

Where are you acting like a gambler chasing their losses, holding out for a jackpot that will fix everything? Take a moment to reflect on where you hold onto false hope.

Where do you tell yourself, “if only…”?

Where are you tapping the metaphorical slot machine button, constantly hoping for a different result?

What forms of endless striving are you engaged in to win the approval of others?

Letting go of your healing fantasy, you recognize their rejection is more about their past trauma or experiences with an emotionally immature parent than about your worth as a person.

It is helpful to view emotionally immature parents as emotionally phobic. If you have a fear of spiders, snakes, heights, or public speaking, consider how you would feel if someone told you that you had to engage with one of these things. This is the experience of the emotionally phobic person.

Discarding the healing fantasy requires accepting your parents for their emotionally phobic selves. This does not excuse their behavior; instead, it allows you to manage your expectations and work with reality.

Emotionally immature people may appear distressed, cynical, and constantly complain, but perhaps they don’t want to change. And in your own experience, how have attempts to change them worked out so far?

Once you have identified your healing fantasy, you can let it go and accept you are dealing with someone who is emotionally phobic.

Step Out of Your Role Self

The role self is the role you played within the family dynamic. Were you a fixer, an avoider, a comedian, an overachiever, or a rebel?

In enmeshed families where emotions are not discussed, playing rigid roles holds the family together. It is a form of dysfunctional homeostasis. By playing your role, you have a place in the family system, but your belonging comes at the cost of your genuine feelings.

Like a stage performance, everyone puts on their costume and stays in character. Talking about the deeper issues requires breaking character, threatening the tenuous sense of belonging provided by the enmeshed system.

Stepping out of your role-self requires noticing the role you play and making a conscious decision to be your true self. This does not mean opening up emotionally to emotionally phobic people. Instead, it means clarifying your genuine values and acting in alignment with this true self.

Clarify Your Values and Your True Self

Stepping out of the role self and into the true self requires trusting your gut feelings and intuition. When do you find yourself in a flow-state where time disappears? What were you like as a young child? What types of things did you naturally gravitate to? What did you enjoy doing? When do you experience moments of true joy? Clarifying your true values provides a compass for how you want to engage with others.

When stepping out of the role self, you may uncover suppressed anger. If you’re an internalizer, you may be perceived anger as unacceptable and dangerous. Since our emotions are like internal check-engine lights, repressed anger leads to unmet needs. The sense of “getting by on fumes” fits well with this metaphor.

Allowing yourself to feel anger does not mean switching into rage and resentment. Anger can focus your attention on unmet needs and motivate action to meet those needs through assertive communication or personal boundaries.

You may have grown up believing certain emotions are “good” or “bad.” Instead, viewing emotions as information, you step outside the need to repress the “bad” ones. There are comfortable and uncomfortable emotions, but they are all there to convey useful information regarding your underlying needs.

Set Personal Boundaries

Setting personal boundaries means saying “no” when you find yourself helping others at the cost of your health. It means recognizing and communicating your needs through assertive communication. Lastly, it means disengaging from toxic relationships.

In another great book on the subject, When the Body Says No, Dr. Gabor Maté says when given a choice between guilt and resentment, choose the guilt. This means noticing when guilt drives your decision to do things for others that you will eventually resent them for.

Choosing guilt means caring for yourself enough to say no. Although there may be a temporary deeply engrained guilt response, this step toward self-care heals underlying shame.

Guilt says, “I did something bad,” whereas shame says, “I’m bad.”

Choosing short-term guilt heals long-term shame. This allows you to gain a sense of self-worth, in turn, healing the constant guilt.

As you build momentum, notice the amount of “shoulds” you tell yourself. Notice how this is potentially the internalized critical voice of a parent. Setting boundaries with your parents means setting boundaries with your own inner-critic, as well.

You can give yourself the compassion you never received. Practicing self-compassion may consist of imagining what you would tell someone you care about who is going through the same situation. Being kind to yourself allows you to heal underlying shame and step back from your thoughts during moments where the inner-critic tries to lower your personal boundaries through the “shoulds” that lead to guilt.

Take an Observational Perspective

After gaining some perspective regarding the nature of underlying shame, guilt, and the inner-critic, it can be helpful to use an observational perspective when engaging with an emotionally immature parent.

An observational perspective means stepping back from interactions within your family system and viewing the situation like a scientist. Perhaps you can imagine you’re an anthropologist like Jane Goodall, studying primate interactions. Get curious about the various roles, reactions, and scripts being acted out. How is everyone falling into their usual role selves?

With this new perspective, you can gain emotional distance from heated situations, noticing your conditioned thoughts and emotions rather than merely reacting. Rather than reacting, you now have space to respond appropriately.

Perhaps this means taking a timeout, politely saying you cannot do something, or maybe it means just doing nothing, accepting you are dealing with an emotionally phobic person stuck in a role self. Whatever the situation calls for, you are free to choose your response based on your core values.

Taking this observational perspective breaks old reactive emotional habits that keep you locked into a toxic dynamic. It allows you to step back and recognize what is really going on. Lastly, it allows you to manage your expectations and deal with reality rather than a non-productive healing fantasy.

Engage in Self-care

Many people have heard about the common self-care tips such as diet, nutrition, sleep, and making time for things you enjoy. These are pretty obvious, and if someone is an internalizer, they’ve probably been told to do these things many times. So why isn’t it enough to simply give this advice?

As you may have noticed by now, internalizers prioritize helping others over helping themselves. The ability to engage in self-care is perhaps part of the healing fantasy, perpetually postponed because there are more urgent matters regarding the needs of others. You may unconsciously tell yourself you’ll deserve self-care when you can finally fix everyone else.

Getting into the classic list of self-care tips is irrelevant if these underlying issues block motivation to engage in self-care. So why would someone continue to engage in self-neglect, even after recognizing this fact?

The most simple answer is because familiarity feels safe. We are creatures of habit, and it is very common to take self-destructive paths because they feel familiar. The sense of uncertainty and fear of the unknown keeps people stuck in suboptimal situations, settling for the scraps rather than taking the bigger, better offer of a new way of life.

If you grew up with an emotionally immature parent, emotional immaturity feels familiar. As a result, you may find yourself attracted to these types of people in other areas of your life. The people we find most charismatic are often triggering us. Therefore, instant chemistry might be a red flag that you are falling into old family patterns.

Before you can think about self-care, you’ll need to let go of these underlying attachments to unhealthy relational dynamics.

Whose validation are you seeking? Do you really need their validation, or do they need you to need their validation? Do you need to be needed? If so, are your attempts to meet this need getting you closer to genuine belonging, or are they keeping you meeting someone else’s need to be needed at your own expense.

For more on this theme, see my article, The Need to be Needed.

Characteristics of Emotional Maturity

If you’ve made it this far, you can probably relate to the sense of feeling trapped in constant emotional turmoil and unhealthy relational dynamics. Once you’ve applied some of the principles listed in the previous section, you may realize these patterns are so familiar and deeply ingrained, it is challenging to spot emotional maturity.

Although we’ve covered the red flags indicating emotional immaturity, here are the positive signs of emotionally mature individuals:

Emotional maturity consists of being realistic, reliable, flexible, non-judgmental, respectful, empathetic, level-tempered, genuine, reciprocal, and having an overall positive vibe.

Emotionally mature people are like a well-designed house. When everything is working the way it should, you almost don’t even know it’s there. If you’re used to constant flooding and leaking, you may initially feel a sense of calm and ease.

Interactions with emotionally mature people are lighter and more effortless. They are generally even-tempered, reliable, consistent, and can meet your basic emotional needs.

They are psychologically flexible and work with reality rather than fighting against it. If you decide to change plans, they respond flexibly, sharing their input and working out a mutually beneficial way forward.

They can use both reason and emotion in a balanced way, depending on the needs of a specific situation.

Emotionally mature people are not perfectionistic and recognize everyone is imperfect. This perspective allows them to demonstrate genuine compassion for others and themselves.

They treat others with respect, honoring your boundaries, and maintain your individuality.

When you need their emotional support, they listen non-judgmentally and empathetically, not assuming they know you better than you know yourself.

They approach life with a win-win mentality. They don’t want to use others, nor do they want to be used by others.

When conflict arises in a relationship, they are willing to deal with it effectively and bring it to a close rather than using emotional manipulation or long-term silent treatment.

Emotionally mature people are willing to consider your perspective and have a secure sense of self, allowing them to approach others with a non-defensive natural curiosity.

They are truthful, genuine, and forthcoming about their thoughts and intentions.

When they make a mistake, emotionally mature people are willing to genuinely apologize, demonstrating careful attention regarding your concern and describe how they intend to do things differently next time, following through with these intentions.

They are genuinely interested in you, remembering specific details regarding your interests and passions, referencing these topics in future conversations. They celebrate your individuality rather than expecting you to conform to their interests.

Emotionally mature people see you positively, allowing you to be yourself, free of the fear of judgment. When you share your emotional needs or discomforts, they take you seriously.

If you share personal details, they reciprocate, building mutual intimacy.

Although they are generally even-tempered, they can laugh and be playful. Their sense of humor is used to connect and bond rather than using it to gossip and ostracize others.

In general, they are enjoyable to be around and have an overall positive vibe.

Most importantly, they make you feel seen and understood for who you really are, not who you pretend to be.

How to Build Genuine Relationships 

If you’ve never experienced a deep relationship with emotionally mature people, this kind of relationship may seem like a pipe dream.

You may be conditioned to settle, take emotional scraps, or be led on by a trail of emotional breadcrumbs. Besides the healing fantasy, it can be hard to let go of these relationships because you may think it’s all you’ll ever get. The thought of being alone forever induces fear, keeping you locked into familiar patterns.

Before letting go of toxic relationships, it can be helpful to assess those in your life, considering who fits the description of emotional maturity. Of course, no one is perfect, but the above description can offer guidance in making this assessment.

If you’ve determined there is someone in your life who is relatively emotionally mature, and you’ve been afraid to reach out for support, notice how the fear of judgment, rejection, or feeling like a burden is keeping you from doing so. Notice how although these reasons may have served you growing up, they are no longer useful when engaging with emotionally mature people.

Taking off the mask and opening up to emotionally mature people helps build an emotional safety net, allowing you to let go of unhealthy relationships.

Emotionally mature people can help you practice being yourself, so you can take this practice into interactions with others who are less emotionally mature. Rather than reacting based on old patterns, you can pause, maintain self-composure, and be true to yourself, whether people accept it or not.

You are not responsible for being parented by an emotionally immature parent, but you are responsible for the recovery process. This means recognizing others are responsible for their own feelings and communicating their needs, just as you are.

Trusting your emotions as offering useful information regarding unmet needs, you can have compassion for yourself. You can then accept that emotionally mature persons will likely respond to you with this same compassion if you reach out for support.

Conclusion

Letting go of old mental habits instilled by an emotionally immature parent gives you the freedom to live by your genuine thoughts and feelings. With this newfound sense of empowerment, wholeness, and self-reclamation, life feels lighter and easier.

Although you can’t make others change, you can change. You do get to start over, almost as if you’re rebirthing yourself, giving yourself the gift of living twice in one life.

This article has been an in-depth summary of the book, Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents by Lindsay C. Gibson PsyD.

If you want even more tools on how to heal from an emotionally unavailable parent, you can check out her follow-up book, Recovering from Emotionally Immature Parents: Practical Tools to Establish Boundaries and Reclaim Your Emotional Autonomy.

As you can probably tell, I have been pretty obsessed with her book, given the time it took to write this summary. As a counselor, this is one of the most common themes I encounter in my conversations with clients.

This issue can often go unnoticed since there may not necessarily be a specific event identified as “traumatic.” Adverse childhood experiences do not need to be physically abusive or neglectful. As you can see, emotional neglect can have significant negative consequences and is often perceived as “normal” by those who have experienced it.

The issue is often made even more invisible because internalizers often blame themselves, carrying significant guilt or shame regarding unhealthy dynamics.

The book provides an insightful perspective, allowing the reader to see the bigger picture, giving practical tools to heal from emotionally immature parents. In the near-perfect 5546 reviews, many people share they found it life-changing, and I can see why.

If you know someone struggling with the issues outlined in this article, feel free to share it with them. Healing invisible wounds starts with awareness of the problem.

Additional Resources

I’ve been on an audiobook binge over the last few weeks and have read a series of great books that would make the perfect follow-up to this article, so I’ve listed them below—in addition to a few others.

If you find yourself struggling with the inner critic, causing you to experience guilt and beat yourself up over “not being enough,” here are my best book recommendations:

Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff PhD

Radical Acceptance: Embracing Your Life with the Heart of a Buddha by Tara Brach PhD

Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Brené Brown PhD

The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind by Daniel J. Siegel MD

When the Body Says No by Gabor Maté MD

If you have further recommendations, feel free to share them in the comments! I am always looking for new audiobooks to devour while driving or doing housework!

My Counselling Toolkit

My Counselling Toolkit

Over the last couple of months, I have been busy sharpening the tools in my counselling toolkit. Due to the pandemic, there has been a high demand for mental health services, leading me to take a new role doing virtual counselling for clients across Canada.

Although I had to take a step back from regular writing, I’ve been getting the opportunity to help many people, gaining valuable lessons along the way.

Thus far, throughout my career in addiction and mental health, I’ve enjoyed collecting and sharpening new counselling tools, learning that having multiple tools at one’s disposal is critical. As they say, when your only tool is a hammer, every problem looks like a nail.

In my experience, effective counseling requires using the right tool, at the right time, in the right way. This does not mean you need to have every single tool in existence. It’s more effective to be a master of a few different tools than to have a rudimentary understanding of many.

My counselling toolkit can be divided into three different sections:

  1. Building a foundation (person-centered approach)
  2. Holding space for emotions (humanistic approach)
  3. Reframing thoughts (cognitive-behavioral approach)

Sticking with the construction metaphor, a person’s thoughts, emotions, and actions are the wood, support beams, and concrete. They are the primary raw materials in counselling.

But before you start building, you need a foundation.

Start with a Foundation

You may be hired to renovate a room, construct an addition, or perhaps just knock down a kitchen wall. Either way, you can’t make assumptions unless you ask your client. This is the foundation of a person-centered approach.

Making assumptions without first asking the client what they want is like a friend asking your opinion on a paint colour, and you tell them how to remodel their home.

You won’t be very helpful if you start making assumptions.

“But what if my friend’s home is falling apart?” you may ask.

If you think someone requires more than they are asking for, there is a time and place to introduce the subject. Perhaps deep down, they realize they need a lot more help but are not ready to address these other areas right now. If they need to paint a room to brighten their day before taking on the rest of their renovations, simply help them choose the paint colour.

Meeting a person where they are at is the foundation of an effective counselling relationship. Like the foundation of a home, the concrete needs to set before you can start building on it.

Tool Required:

The Open-ended Question

Laying the foundation to a strong counselling relationship by meeting someone where they are at does not require fancy tools, but it can be easily overlooked.

When someone presents a set of problems, it might be tempting to try to address what we perceive to be the most important issue first.

Rather than starting with an assumed priority, I like to get a sense of what is going on, then directly ask an open-ended question like the following: “what would you like to get out of our work together?”

This is the core of solution-focused counselling and single-session counselling. There is often a misunderstanding that counselling has to be a long and drawn-out process that explores every aspect of someone’s past. This might be helpful in certain situations, but it is not necessarily what everyone needs during a session.

Another open-ended question might include the following: “By the end of this session, what would tell you this has been a helpful conversation?” or “If you get what you want out of this conversation, what would it allow you to do tonight or tomorrow?”

By starting with the end in mind, I can quickly determine what kind of conversation this is going to be. In my experience, counselling conversations generally fall somewhere on a spectrum between two broad categories: 1) conversations for support and 2) conversations for advice.

Conversations for support generally involve persons simply looking for someone who will listen with compassion, facilitate a sense of connection, and offer validation that they are doing the best they can. Clients often express this as “just wanting to know I’m not crazy” or “I just need to vent.”

Let’s take a closer look at the best tools for these types of conversations.

Hold Space

When determining the primary goal is to support a client who simply needs a compassionate ear, I immediately switch to my set of connection tools for holding space. These tools are the essence of a humanistic counselling approach.

Many clients, especially those in crisis, just want to feel heard. They have often felt dismissed or not understood by friends, family, colleagues, or other professionals. This leads to a sense of isolation or perhaps even shame.

The best way to hold space is to simply listen.

I originally learned about holding space from Heather Plett in this article:

It means that we are willing to walk alongside another person in whatever journey they’re on without judging them, making them feel inadequate, trying to fix them, or trying to impact the outcome. When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.

To continue with the construction metaphor, it’s like adding strong supportive beams in a building. They are non-imposing and usually invisible, but their strength allows a structure to hold space, keeping the occupants inside safe.

In counselling terms, this means compassionately being with another person with complete acceptance, allowing them to feel held by your presence, and safe to express whatever they need to.

Let’s consider a few other tools that can help hold space more effectively.

Tool required:

Reflective Listening

Reflective listening means showing the other person you understand rather than simply saying, “I understand.”

How do you do this?

Although we can never really understand exactly what another person is going through, we can do our best to show we get it, on some level. We may not have been through the same experiences, but we all feel the same emotions from time to time and can connect with another person’s experiences through this shared humanity.

Even if your understanding is imperfect, just showing you are trying to understand can be enough. This is the core of empathy.

Reflecting back what you understand the other person is saying demonstrates this empathy.

It can be as simple as saying, “wow… you’ve been through a lot recently.” or it could be a brief summary of everything they’ve shared. The key is that it comes from a place of genuine compassion.

Here is an example of a more complicated form of reflective listening whereby you prompt the person to continue by saying the statements you believe they may say next:

Person: “I’m here because I find it difficult to control my drinking.”

You: “…and you’re looking to gain back some control.”

Person: “yeah… I miss the way things were with my family before I started drinking.”

You: “… spending quality time with the ones that matter.”

Person: “That’s right…”

Reflective listening is the primary tool I use to hold space. It allows the other person to feel safe and understood.

Although reflective listening is a tool, holding space goes beyond one’s words. It is an attitude and way of being with the other person. There is no need to change anything or fix anything in these moments. Just simply being with the other person during these difficult moments is often all they need.

Reframe Thoughts

If a client is ready to start developing new coping skills, I take out a different set of tools to work with their underlying unhelpful thoughts. This is the foundation of a cognitive-behavioural approach.

At the core of self-destructive actions, there are often unhelpful thoughts. For example, a person struggling with an addiction is not simply chemically hooked to a substance. Although there may be physical dependence, it often goes much deeper.

Past traumas or chronically unmet needs can result in distorted perceptions of oneself and the world. For example, this is common for people who grew up with emotionally unattuned parents struggling with mental health or addiction issues. Growing up in this environment can lead to distorted beliefs and habits that were adaptive in this early environment but become maladaptive in adulthood.

Common distorted self-perceptions include thoughts such as the following:

  • I am not enough
  • I will be a burden if I ask for help
  • I’m bad/ broken/ hopeless
  • I’m undeserving
  • I’m unlovable
  • I’m worthless

Continuing with the construction metaphor, these thoughts are equivalent to a distorted wall, throwing off the alignment of a room. This would require reframing some of the walls, but the walls need to be deconstructed before reframing can be done.

In conunselling terms, this means getting to the root of unhelpful core beliefs.

Tools Required:

Identifying Core Beliefs

Deconstructing one’s thought processes to identify core beliefs should be done carefully. Like knocking down a wall, getting too reckless with the hammer could indirectly affect other areas of the house.

I generally ask what thoughts are going through their head during a challenging moment. For example, if someone is anxious every time they walk into work, I may ask them to imagine they are in that situation and share what might be going through their head at that moment.

If they are struggling to think of something or they begin to notice discomfort in their body, I will ask them to describe this discomfort in detail. Where is it located in the body? What does it feel like? I then ask if this discomfort had a voice, what would it say?

Responses might often include, “You’re going to mess up.” I would then go further, asking if this were true, what it would mean about you as a person. A response might include, “I’m going to lose my job.” Since this does not directly answer the question, I might ask what this would mean about them as a person. A common response might include, “I am not enough.”

Unhelpful core beliefs are distorted ideas about oneself, often extending into many areas of one’s life. For example, the core belief of not being enough often extends beyond isolated events such as worries about one’s work performance. It can affect one’s level of self-worth in all relationships, leading to frequent feelings of fear and unhelpful behaviors such as avoidance or overcompensation.

Unlike reframing a room in a house, reframing core beliefs does not merely require knocking down the old one and constructing a new one. Since core beliefs have often been around so long, they tend to pop back up frequently.

There is no process of unlearning in psychology. There is only new learning. You can’t just knock down the wall and burn the lumber. You have to use the same lumber to reconstruct the new wall.

In counselling terms, reframing these beliefs often requires putting them into a new context. For example, rather than unconsciously going through life with “I’m not enough,” we can identify where it may have come from and how to let go of it when it returns.

In this particular example, a person may share a highly invalidating upbringing with parents who frequently criticized them for not being good enough. Bringing this core belief to light and tracing its origin gives it a new context. It can then be held as an unhelpful thought that has been learned from one’s past experiences.

Gaining this perspective allows a person to step back from these unhelpful thoughts and reframe their meaning.

Cognitive Defusion

This is a fancy-sounding concept in Acceptance and Commitment Therapy (ACT), referring to one’s ability to step back from one’s thoughts.

When we are fused with unhelpful thoughts, they become heavy and weigh us down. We identify with the self-critical thought rather than noticing it’s just a thought and letting it go.

A popular metaphor in ACT includes the leaves on a stream visualization. It consists of imagining you are sitting beside a stream with leaves floating down it. Bringing your attention to your physical sensations, you step out of overthinking and into the present moment. If a thought comes in, place it on a leaf and watch it float by. If you would like to try this exercise, you can find a guided version of it on YouTube here.

The goal of this exercise is not to merely float into a dreamlike bliss where you stop identifying with every thought, going through life in a state of idyllic apathy. The goal is to practice stepping back from unhelpful thoughts, allowing you to focus on things you value.

For example, when “I’m not good enough” shows up, it can be used as a reminder that you care about a particular situation, such as doing quality work. You can then thank your mind for the reminder that you value your job and that you will not get hooked by this unhelpful thought right now.

Although you are working with the same lumber, you now have the blueprint. Having a broader perspective on the situation allows you to respond in ways that are more self-compassionate, increasing the chances you will act effectively.

Self-Compassion

This is another major tool I tend to use in reframing.

If people talked to their friends how they often talk to themselves, they wouldn’t have many friends for long.

People often beat themselves up with phrases such as, “I’m bad, I’m stupid, I’m crazy….” This lack of self-kindness cuts a person off from common humanity, making them feel uniquely defective and isolated. It then reinforces unhelpful worries and behaviours, decreasing the odds of effectively handling difficult situations.

After identifying and reframing core beliefs, I find it helpful to bring up the concept of self-compassion.

I often introduce self-compassion by asking how a person would talk to someone they care about going through the same situation. I then have them confirm this is the most helpful way to engage with someone and that harshly criticizing this person would be counterproductive.

I would then draw attention to the interpersonal process we’ve been engaged in over the session. If I were to constantly criticize them through the session, would this improve their chances of changing? They often immediately resonate with how unhelpful this would be.

After getting their full agreement on these examples, I suggest the same applies to how they talk to themselves. I then inquire into their thoughts after noticing this tendency and ask if it would be possible to pretend they are talking to a friend, next time they notice a lack of self-compassion.

Perspective-Taking

When designing a room, the space can look very different, depending on your perspective. Perhaps we’ve become more familiar with this idea, given the increased use of videoconferencing from home. From the frame of a carefully placed webcam, a space can look clean and organized, but it can look very different from another perspective.

For me, perspective-taking has been a powerful reframing tool. I find it to be most beneficial among persons who are caught up in their view of a situation, unable to empathize, or have rigid beliefs about someone else’s intentions.

For example, if someone rigidly projects specific intentions onto their partner’s actions, perspective-taking can help determine a more accurate interpretation of events. This is particularly helpful if these unhelpful interpretations include concerns about one’s adequacy. In this way, perspective-taking can be a multi-purpose reframing tool that can also initiate cognitive diffusion.

This kind of reframing should be done carefully since you can unintentionally break the foundation. For example, asking how the other person views the situation can be interpreted as invalidating and appear as if you are supporting the other person’s behaviour.

When using perspective-taking, it is helpful to have a solid foundation of trust and approach it carefully, inviting the person to see the situation from behind the other person’s eyes. If approached with a spirit of curiosity and openness, it can lead to significant insights.

Conclusion

My goal in this article has been to reflect on my counselling toolkit. Hopefully, this has also been beneficial for you. 

If you are a fellow practitioner, perhaps it has offered some ideas for your toolkit. If you are someone who is looking for support, perhaps it has debunked some myths about counselling and provided a few insights.

When sharing my role with others, people often ask, “what do you tell people?” As you can see in this article, the answer is always, “it depends.”

Asking me what I tell people is equivalent to asking a home builder what tool they use. It depends on what needs to be done at that moment.

But unlike construction, counselling can often be most productive when doing less. I heard a great quote recently by Judson Brewer in his new book, Unwinding Anxiety. He says, “don’t just do something… sit there.”

People who value compassion often feel compelled to rush in with their shiny well-stocked toolbox and try to fix things. I have to remember this every time I begin a conversation.

Although I used a repair-oriented metaphor throughout, the metaphor has its limits. Counselling is not about “fixing” people.

Taking a “fixing” orientation assumes people are broken and puts them into a passive role within the dynamic. This disempowers them in two ways. Implying they are broken can reinforce unhelpful self-critical thoughts. Also, placing someone in a passive role takes away a core ingredient of motivation; it takes away their sense of autonomy, self-efficacy, and sense of incremental mastery.

I’ve written about this collaborative approach to counselling in my article on how to do motivational interviewing here.

While exploring my counselling toolkit, I also realized there are way too many tools to fit within one article. If you are interested in taking a more detailed look inside my ACT toolkit, check out my article on how to improve psychological flexibility, here.

Looking For Your Feedback

One of the most common questions I’ve been hearing is, “how do I stop overthinking?”

That is why I’ve recently started developing an online course designed to help people stop overthinking and start living the life they want.

In this program, my goal is to guide the client through each step of the process with self-guided video modules, worksheets, and practical exercises.

Although I’ve been carefully constructing this course outline over the last few months, I want to make sure it is the best it can be.

That is why I am asking for a huge favor.

If you are interested in contributing your feedback, please answer the following questions to make this course as helpful as possible.

Answers will remain anonymous. Since I am not asking for any identifiable information, I will not be able to respond to any of the submissions. Just know I appreciate the support, and I will be reviewing your feedback carefully.

The Myth of the Addictive Personality

The Myth of the Addictive Personality

The idea of an “addictive personality” is one of the biggest myths about the cause of addiction. Rather than explaining addiction, it reinforces popular misconceptions, often stigmatizing those who suffer from an addiction.

Regardless of one’s personality, addiction can affect anyone. Although specific personality characteristics can be correlated with certain types of addiction, the idea of a single “addictive personality” grossly oversimplifies addiction.

As I explained in my article on the underlying causes of addiction, it is a complex issue with several potential contributing factors:

The underlying causes of addiction include trauma, unmet needs, or other emotionally painful experiences resulting in the desire to cope in the short-term through substances or behaviors that mask the pain, resulting in long-term harm. 

With this in mind, let’s consider the various reasons why it is important to dispel the myth of the addictive personality.

There Is No Scientific Consensus 

Researchers studying the correlation between personality and addiction have been unable to reach a consensus regarding a single “addictive personality.” Instead, many studies have found the importance of specific traits that may differ across each type of addiction.

Although there is no consensus regarding an addictive personality, one of the most significant traits observed in the research is low self-regulation. Low self-regulation means having difficulty controlling impulses, but it can also mean difficulty pulling oneself away from narrow areas of focus. On one end of the personality spectrum, low self-regulation can look like hyperactivity, while on the other end, low self-regulation can look like obsessive focus.

In Maia Szalavitz’s book, Unbroken Brain, she analyses the past twenty years of “addictive personality” research, in addition to sharing her own experience with an addiction to heroin and cocaine. As an anxious straight-A student who always followed the rules, no one suspected she would develop an addiction. She states:

“Children who ultimately develop addictions tend to be outliers in several measurable ways. Yes, some stand out because they are antisocial and callous—but others stand out because they are overly moralistic and sensitive.”

Rather than being about a single personality type, there are various personality types associated with increased risk. These personality types are generally found on opposite extreme ends of an impulsivity spectrum. As she states:

“While those who are the most impulsive and eager to try new things are at highest risk, the odds of addiction are also elevated in those who are compulsive and fear novelty. It is extremes of personality and temperament—some of which are associated with talents, not deficits—that elevates risk. Giftedness and high IQ, for instance, are linked with higher rates of illegal drug use than having average intelligence.”

We often think of persons with low self-regulation as lacking impulse control, as in the stereotyped image of ADHD. What is often neglected is how compulsiveness, at the opposite end of the personality spectrum, is also associated with low self-regulation. Maia Szalavitz shares her personal experience with this issue:

 “I had trouble stopping intellectual engagement, not starting it.”

As someone with mild work addiction, I can personally relate to this issue. From the outside, completing a PhD and writing over 80 articles on this site looks like a high degree of self-regulated focus. However, I experienced it as quite the opposite. Not doing these things would be more difficult since it takes an active effort for me to stop doing them, similar to a person trying to stop using substances.

Luckily, this is something I have insight into, so I carefully monitor it to minimize negative impacts on other areas of my life. To learn more about this balance, check out my article on when something becomes an addiction.

Although I have been able to turn this tendency into an asset, it could easily cause destruction if it results in too much neglect in other areas. Also, this tendency can easily become fixated on other addictive substances or behaviors if not kept in check.

Addiction is found in the extremes of a spectrum. Too often, addiction is classified as something you either have or don’t have. Rather, you can be mildly addicted to something if it has minimal harm in your life or severely addicted to something if it has a significant negative impact.

In the same way that addiction is not merely something you have or don’t have, it is a complex issue that does not look the same for everyone. Addiction is strongly associated with low self-regulation, but the way low self-regulation manifests looks different for everyone.

A 2018 study on the personality profiles of addiction found that different types of addiction attract different types of personality. Regarding these trends, the study found the following:

• Alcohol use disorders identified by lower extraversion and openness to experience.

• Drug use disorders and compulsive sexual behavior have similar personalities.

• Gambling disorder has similar personality to healthy controls.

These correlations provide further evidence against the idea of a single “addictive personality.” It is also interesting to note that persons with an addiction to gambling did not differ from the personality of the general non-addicted population. Regarding gambling disorder, the study concludes:

“…treatment centers and counselors may need to address environmental issues in these individuals, rather than focusing exclusively on risky personality traits.”

I’d go even further to argue that although there are some general trends in personality differences between various types of addiction, it is always necessary to treat individuals based on their unique personality traits, character strengths, and personal histories.

Although the science is relatively clear on the importance of self-regulation in addiction, even this concept manifests quite differently across each individual. There is no substitute for a person-centered approach to addiction.

It Does Not Explain Addiction

Rather than clarifying why someone may have developed an addiction, the concept of the addictive personality obscures the underlying causes, reducing everything to a perceived personality defect. Like the myth of a single “addiction gene,” we tend to seek simple answers to complex questions. In doing so, we gain certainty at the cost of genuine understanding. Although an array of genetic factors may contribute to an increased risk of developing an addiction, there is no single addiction gene.

These simplistic single-origin explanations label persons with addiction as fundamentally different. This false certainty can give the illusion that one is immune from developing an addiction if one does not exhibit certain traits.

The concept of an “addictive personality” is a convenient way to package addiction’s messy reality into the black box of a pseudo-psychological label. The concept’s explanatory power is equivalent to saying, “they have an addiction because they are an addict.”

Addiction is caused by various factors and the concept of an “addictive personality” erases this reality by simply attributing all addiction to a single variable. As shared in my article on what drives addiction:

“Addiction is driven by neurological changes related to dopamine, the reward center, and the brain’s self-regulatory center. This produces a learned pattern of coping with underlying pain or unmet needs.”

This brief explanation does not even scratch the surface, so check out the full article for further detail if you are interested.

It Can Be Stigmatizing 

Such superficial explanations are also stigmatizing. An example can be seen in the stereotyped concept of the “degenerate gambler.” Like the idea of the “addictive personality,” concepts like “addict” often carry the weight of judgmental attitudes. Although persons in 12-step recovery may choose to identify themselves as a “gambler, alcoholic, or an addict,” it is not anyone else’s place to bestow such a label.

I interact with “persons with an addiction” in the same way I would interact with “persons with depression.” I wouldn’t walk into a mental health rehabilitation unit and refer to the clients as “depressives.” The comparison is not perfect because the “addict” labels have become normalized in 12-step recovery, but using the label for oneself is a personal choice.

When these labels are appropriately internalized in the context of 12-step recovery, they can be empowering. When they are given to you by someone else, they can feel alienating. Introducing oneself as an addict at a Narcotics Anonymous meeting feels very different than someone else saying, “You’re an addict.” The former indicates acceptance and the desire to maintain abstinence, whereas the latter often suggests judgment and misunderstanding.

The concept of an addictive personality can serve as a permanent mark of “defectiveness,” taking away hope in a situation already marked by a lack of hope. As shared in my article on stigma, Stephanie described her constant fear of judgment while in active addiction.

“I was hopeless and believed that I would not be able to get help. In my own head, I was a lost cause.”

When someone feels judged, they are less likely to reach out for help, prolonging their struggle with addiction. The concept of the addictive personality may contribute to this issue when the label is perceived as a form of judgment.

Conclusion

The concept of the addictive personality has been one of the most stubborn myths in the addiction field. Although persons lacking self-regulation are at an increased risk of addiction, issues in this area range from hyperactivity and impulsiveness to obsessiveness and compulsivity.

Each type of addiction has a different general trend in personality traits. Although this is the case, these trends are still not necessarily useful in clinical settings where each individual brings their unique cluster of personality traits, character strengths, and personal histories.

Lastly, relying on the concept of an addictive personality can be stigmatizing since it tends to be an overgeneralization based on a set of stereotyped negative characteristics.

The concept of an addictive personality is not useful for explaining addiction, nor is it helpful in treating addiction. As described in my article on the root causes of addiction, the causes of addiction include trauma, pain, and unmet needs such as purpose, belonging, and self-esteem. As in the insightful words of Gabor Maté:

“The question is not why the addiction, but why the pain.”

If you want to learn more about the lived experience of addiction, check out my article, What Does Addiction Feel Like?

To learn more about our underlying psychological needs, check out my article, What Are Our Underlying Needs?

For more on the root causes of addiction, check out my interview with Stephanie from Aegis Health Group:

As an addiction counselor, my approach to helping clients is based on recognizing these underlying factors. Recovery results from effectively turning toward the underlying pain in a self-compassionate way, uncovering core values, and building habits of committed action.

If you reside in Canada, I am currently taking clients for online counseling, in addition to in-person sessions for persons who live in the Windsor-Essex area. If you are interested in learning more, you can fill out the form below, and I will contact you for a free 15-min phone consultation.

Underlying Causes of Addiction

Underlying Causes of Addiction

When considering the underlying causes of addiction, it is important to remember there is no universal answer. As an addiction counselor, I have met various individuals with unique stories and have observed how addiction generally results from some form of pain. As explained in my article on the root causes of addiction, these forms of pain may include trauma, intrusive thoughts, or unmet needs.

Although each person has their own unique story, I’ve noticed some general trends that explain why certain people may be drawn to certain substances or behaviors to cope with underlying pain.

The underlying causes of addiction include trauma, unmet needs, or other emotionally painful experiences resulting in the desire to cope in the short-term through substances or behaviors that mask the pain, resulting in long-term harm. 

Addictive substances or behaviors provide the illusion of one’s need being met while further taking one away from genuinely meeting their needs in the long-term. Throughout this article, I focus on how specific substances or behaviors are generally used to escape from the pain of specific unmet needs.

As stated before, I have encountered many exceptions to these general tendencies. In this article, I draw on Stephanie’s experience, a fellow recovery advocate who is in long-term recovery from stimulants and opioids. Her experience illustrates some general patterns I have observed, but as always, it is essential to assess each individual independently to determine their underlying unmet needs.

I share Stephanie’s fuller story of addiction and recovery here, and you can contact her on Facebook here. You can also check out an interview we did for Aegis Health Group on YouTube here.

Underlying Causes of Addiction to Stimulants

Some common stimulants include cocaine/ crack, crystal-meth, and other amphetamines. Producing a stimulating effect on the central nervous system, they often make users feel energized, confident, and powerful.

Of all the substance categories, stimulants produce the highest levels of dopamine response in the brain. This neurological effect is responsible for the increased risk of psychological addiction since dopamine is the primary neurotransmitter associated with addiction, as explained in my article on what drives addiction.

An underlying cause of addiction to stimulants is low self-esteem. Simulants offer a short-term escape from the pain of low self-esteem. This is reinforced by the high levels of dopamine production in the brain, causing a sense of confidence and invincibility. 

Stephanie shares the following experience:

“The first time I did cocaine, I felt like I was invincible. If I spoke, I said all the right things; if I danced, I hit every move perfectly. It was the first time I felt completely confident in myself. When you use coke, you have a lot of friends. Being picked on most of my life, being the popular girl was just as enticing as the drug. For once, I felt what I thought was happy, on top.”

This initial experience reinforced the brain’s learning mechanism in the dopamine pathways since a significant source of pain had been unexpectedly solved.

Like figuring out how to hunt a large animal successfully, resolving the hunger pains of our ancient ancestors, the dopamine response reinforces the importance of continuing the specific behavior that preceded the relief of the pain.

This learning mechanism has been fundamental to acquiring new skills to solve problems throughout human history. The dopamine response is mainly triggered when the reward is unexpected. Stephanie shares that the first time she used cocaine in a similar way. She described it as an “ah-ha!!! Moment”. Stephanie shared the following regarding her unmet need for self-esteem:

“All my life, I grew up believing I was ugly, stupid, weird. I felt unlovable and ostracized. When I did coke, none of that mattered. I was beautiful and smart and funny.”

Although low self-esteem is a common cause of stimulant addiction, there are many other underlying causes. Another common situation I’ve encountered includes the use of stimulants to regulate one’s focus.

This is particularly common among persons who have ADHD. Rather than feeling agitated and aggressive, stimulants can have a calming effect by strengthening parts of the pre-frontal cortex, increasing one’s ability to regulate one’s focus. Research demonstrates the relationship between untreated ADHD and cocaine use.

Many people abuse stimulants for reasons beyond those mentioned here. These are just some of the major themes I’ve encountered, shedding light on some common causes.

Underlying Causes of Opioid Addiction

Common opioids include substances such as heroin, Oxycodone, and Fentanyl. Opioids are central nervous system depressants which also have an analgesic effect. This means they are calming and have a pain-relieving effect.

Of all the substance categories, opioids produce the highest risk of physical dependence. The intense pain produced by the withdrawals contributes to the highly addictive nature of these substances. Working in a withdrawal facility, I witnessed many people going through this fierce agony first hand. At its worst, it looked like a demon was trying to escape their bones. If you want to learn more about opioid withdrawals, check out my article, What Does Opioid Withdrawal Feel Like?

The withdrawal of opioids is so powerful due to the rebound effect. This means the withdrawals are generally the exact opposite of the effect produced by the drug. Opioids produce an intensely soothing effect, often compared to a warm hug.

Underlying causes of opioid addiction include lacking a sense of being loved, feeling isolated, or dealing with a great deal of emotional pain, in addition to the high level of physical dependence facilitated by this class of substances.

Stephanie shares her experience with opioids as the following:

“When I did opiates, I was in another failing relationship. The one that was supposed to love me was the one making me feel unlovable. He was constantly putting me down and cheating on me. The first time I ever used, I felt this warm hug wash over me, and the pain of the abuse went away. I was numb, and if he started in on me again, I would just close my eyes a tune him out. I didn’t care. It was the only thing that made me feel the way I did when him and I first met, and I was lying in his arms. I found a way to have that without him.”

Just as painkillers numb physical pain, they also numb emotional pain. Recent research demonstrating this effect studied the impact of acetaminophen on social rejection. Although painkillers numb emotional pain, this effect is fleeting since tolerance to opioids rapidly builds. This causes users to require a significantly larger dose over time to maintain the same effect.

Stephanie describes this experience as the following:

“The warm hug wears off and is only there for a fleeting second. It’s all just to stay normal.”

Like all addictions, the initial effect fades, and the primary purpose of using becomes an attempt to feel somewhat normal. Due to the physically addictive nature of opioids, the pain of withdrawal is continually looming on the horizon.

Although opioids can produce intense pleasure, it is a myth to assume everyone responds the same way. Research demonstrates a large variability in individual subjective responses to opioid use. I have witnessed this in my encounters with individuals who have used opioids primarily as a way to be more productive or function better at work.

Although opioids are a central nervous system depressant, some users report having more energy and the ability to complete tasks they would otherwise find boring. This same response is also found in the ability to stay up later, get up earlier, or be more productive in the gym. Although these things are often associated with stimulant use, opioids can facilitate this type of response by numbing the painful elements of these tasks, making them easier to complete.

Like stimulants, there are a variety of potential responses someone can have to opioids. Therefore, it is essential to consider how each individual is affected by the substance and what they are using it to achieve.

Underlying Causes of Gambling Addiction

Although many people understand how substances can be addictive due to their composition and direct chemical effect on neurophysiological processes, it might be hard to understand how behaviors such as gambling and gaming can have the same effect.

The underlying causes of gambling addiction include random rewards that hijack the brain’s dopaminergic reward mechanism, combined with the illusion of hope for winning back losses, the desire to escape from emotional pain, and a sense of belonging or specialness.

Recall the previous description of dopamine and the brain’s reward mechanism. Gambling hijacks this reward system due to the unpredictable nature of random rewards. Newer slot machines are designed to heighten this dopamine response even further by incorporating several features that result in more opportunities for a surprise. False wins, free spins, and bonuses are some of these features.

False wins are spins where a “win” is triggered, but the amount you receive is less than the amount you bet. Since dopamine responds to the surprise more than the amount won, false wins provide the opportunity for more frequent surprises without having to pay out.

Free spins are another common feature that allows the machine to surprise the player, often accompanied by special graphics or sounds. Like false wins, they allow the machine to incorporate further surprises without necessarily having to pay.

This sense of constant anticipation is a common feature of gambling addiction. In the beginning, it may start as a sense of hope for a better future. As reported in a Vice article:

“People don’t play the lottery because they expect to get rich. They play the lottery because it’s fun to indulge in the fantasy that, one day, their lives could suddenly get easier.”

Like opioid addiction, the warm glow of this glimmering hope quickly dissolves into desperation and the need to escape underlying pain.

In an article in The Guardian, Craig shares this experience:

“Gambling for me wasn’t about chasing the big win, it was about chasing the money I’d already lost.”

From the outside, gambling can seem like an activity focused on greed. For someone with a gambling addiction, the issue goes much deeper. It’s often not about the money. Instead, it is primarily a way to escape a painful reality. According to a participant in a study published in the Journal of Gambling Issues:

“It’s just been a nice escape for me, so even though it causes me grief at times, it’s an escape from reality… I think that’s the basic reason… to get away from reality, just go to a fairy world. Yeah, it’s an escape; wherever your mind blanks out, you don’t think about it. That’s it, your little hideaway, on that chair.”

Just like any addiction, short term relief comes at a long term cost.

Other common underlying features of gambling addiction are the thrills, the social environment, and the sense of importance.

When someone lacks a sense of belonging, they often cope by seeking out status or specialness. Casinos are built around this principle, fostering status and specialness through elaborate marketing and reward programs.

Casinos often have multiple tier-leveled membership programs based on the amount someone wagers throughout the year. With names like Gold, Platinum, or Diamond status, members strive to achieve the next level, giving them special access to parking, entrances, rooms, trips, and events.

Casino hosts are sent real-time electronic information on where members are playing, how much someone has spent, and any other relevant information such as birthdays. Members are greeted by name at their machine or table and offered incentives. Of particular interest are players spending increasing amounts of money.

Other common casino incentives include invitation-only gift giveaways where players are mailed an invitation to visit the venue to pick up a gift, which often consists of everyday household items like pots and pans.

Casino’s have a culture of their own, continually facilitating a sense of specialness. The casino marketing machine can artificially meet this need for those who are socially isolated or suffer from low self-esteem. Many people describe the casino as the only place they feel like “somebody.”

There are many underlying reasons for being drawn into a gambling addiction, most of which are not about the money. If anything, money becomes devalued to the point of feeling fake. Casinos and online gambling venues help facilitate this further by turning dollars into chips or credits.

Over time, these numbers merely signify how much longer someone is able to continue their escapism. At the extreme end, some people even become annoyed or agitated when they win a jackpot because it takes away their ability to continue playing, as they wait for venue staff to pay them out manually. At this point, money becomes nearly irrelevant, and the need to continue playing becomes the sole reason for playing.

Like all addictions, each person with a gambling addiction has a unique experience. Although I have presented some common underlying causes, one must fully inquire into how each individual experiences gambling to get their full perspective.

Underlying Causes of Gaming Addiction

As described in my article on why video games are addictive:

The underlying causes of gaming addiction include their ability to meet our basic psychological need for a sense of autonomy, purpose/progress, and social connection. Many games also incorporate random rewards, similar to gambling, in “loot boxes.” 

Video games provide an environment to experience a sense of autonomy/freedom from social constraints, reduced social anxiety, and allow for a sense of adventure. This is particularly relevant for persons who feel stuck, constrained, or bored/dissatisfied in their offline life.

Video games also provide a sense of purpose and progress through a mission orientation and the ability to level up. This is particularly relevant for persons who lack a sense of purpose in their offline world. Games offer this through various forms of leveling up in addition to encouraging a flow state where players feel completely immersed in the activity.

Video games also provide a platform for individuals to gain a sense of social connection with like-minded individuals. This offers a sense of connection that is particularly relevant for persons feeling isolated. Multiplayer online games can facilitate this through a team environment, whereas single-player role-play games provide an experience where you feel connected to a grand narrative imitating a hero’s journey.

When one’s underlying need for autonomy, purpose, and connection is unmet in one’s offline environment, games can be used to meet these needs virtually. Although gaming can be a healthy way to meet these needs when done in moderation, gaming addiction makes one psychologically dependent on games. Meeting one’s needs through games at the expense of meeting them in non-gaming environments further reinforces the appeal of gaming, making it more challenging to meet these needs offline.

Like all addictions, when gaming is used as a way to escape from pain, it can have long-term costs when the underlying issues are unaddressed.

Conclusion

This guide to the underlying causes of various types of addiction is not meant to be a strict template, but rather, a general way of understanding how certain substances or behaviors are commonly experienced.

At the core, persons with addiction are attempting to fill a void, escape from pain, or meet an unmet need. Although there is significant overlap between each substance/behavior, the specific details presented here are meant to help you gain deeper insight into the common subjective experiences of those struggling with addiction.

If you want to learn more about the subjective experience of addiction, check out my article, What Does Addiction Feel Like?

To learn more about our underlying psychological needs, check out my article, What Are Our Underlying Needs?

For more on the root causes of addiction, check out my interview with Stephanie from Aegis Health Group:

As an addiction counselor, my approach to helping clients is based on recognizing these underlying factors. Recovery results from effectively turning toward the underlying pain in a self-compassionate way, uncovering core values, and building habits of committed action.

If you reside in Canada, I am currently taking clients for online counseling, in addition to in-person sessions for persons who live in the Windsor-Essex area. If you are interested in learning more, please complete the form below, and I will contact you for a free phone consultation.

What Drives Addiction?

What Drives Addiction?

When considering what drives addiction, there are many misconceptions. Persons with an addiction are not merely lacking will-power. Instead, they are coping with underlying issues through addictive substances or behaviors, causing long-term changes in the brain that make it difficult to escape the cycle of addiction.

As an addiction counselor, this is something I’ve learned both academically and through experience working with clients using addictive substances or engaging in addictive behaviors.

Addiction is driven by neurological changes related to dopamine, the reward center, and the self-regulatory center in the brain. This produces a learned pattern of coping with underlying pain or unmet needs. 

Let’s unpack this statement and make sense of what drives addiction in more specific terms.

The Neurological Drives 

Although addiction is often called a disease, recent research finds it is more aligned with the brain’s learning mechanisms. Therefore, addiction is a learned behavior, reinforced by the chronic use of a substance or behavior to stimulate pleasure or provide relief from pain.

For example, imagine you regularly carry a high level of stress or anxiety. When getting home from work, you drink a few alcoholic beverages to relax. Over time, this becomes a habit, requiring more alcohol to gain the same effect.

This is an unconsciously learned behavior because your brain discovers that the use of alcohol solves your current problem. The part of your brain learning this short-term adaptive behavior is distinct from the part of your brain in charge of higher reasoning that would rationally know this is not a long-term solution.

Let’s roughly distinguish between two major parts of the brain: the higher brain and the lower brain. This will be a rough neurological sketch, focusing on the main aspects relevant to addiction.

The higher brain is the rational outer layers developed later in evolutionary history. According to research, the most recent area is the pre-frontal cortex, located around the forehead, which is especially developed in humans. This part of the brain regulates emotions, providing impulse control.

The lower parts of the brain are involved in emotions and motivation. The central part involved in motivation is the Ventral Tegmental Area (VTA). The VTA produces dopamine, sending most of it to the pleasure center (Nucleus Accumbens), providing a reward. These rewards are triggered when you solve a problem, reinforcing this particular behavior. This is how behavior is learned and how we can adapt to new or challenging situations.

This learning mechanism in the lower parts of the brain is focused on short-term gains rather than the long-term planning associated with the higher brain. In any area of life, motivation is produced through dopamine production in the VTA when you successfully complete a novel task. This is particularly powerful when the reward is unexpected, as in the case of gambling. 

Although this process occurs primarily outside of the upper brain’s higher-order reasoning, the upper brain then gets consulted after the fact. The reward experienced in the lower brain gets communicated to the upper brain, telling it to make sense of this situation and plan for future scenarios where this behavior may need to be drawn on. For example, your upper brain will rationalize why it’s a good idea to continue using alcohol to cope with stress, in addition to planning for continued drinking.

This is a rough outline of the major neurological forces driving addiction. Beyond brain circuitry, the content of thoughts is also important, so let’s consider the cognitive realm.

The Cognitive Drives 

Simply put, cognition means the realm of thoughts. This activity occurs in the upper brain and is highly intertwined with the language centers. In the case of addiction, this can refer to the beliefs one has about oneself or one’s behavior.

For example, as previously mentioned, you may develop reasons why addictive behavior is necessary or beneficial. Perhaps drinking after work each evening is justified by the thought that it makes you a better parent since you are less stressed.

Addictions are often based on illusory ideas about unmet needs. For example, alcohol may promise relaxation, gambling may promise hope, opiates may promise love, and cocaine may promise self-esteem. These false promises are reinforced by the short-term effects of the substance or behavior, blinding you from the long-term consequences. Even when these consequences are recognized, the substance or behavior disguises itself as the savior.

Beyond the illusions and rationalizations that drive addiction, one’s thoughts about oneself are also an underlying driver. For example, many people are driven to addictive substances or behaviors to cope with the anxiety produced by the belief that they are not good enough.

These underlying thoughts regarding one’s self-worth may go back to childhood. Whether or not there was a major traumatic experience, many people internalize thoughts about themselves that were reinforced by others around them.

Growing up with the constant thought of not being good enough may escalate throughout one’s life, especially while taking on further responsibilities in adulthood. This can result in underlying anxiety regarding one’s ability to handle future situations, affecting one’s self-esteem as well.

This cascade of negative thoughts regarding oneself can lead to substances or behaviors as a form of short-term coping. As previously discussed, this short-term relief triggers the brain’s reward pathways, reinforcing a long-term pattern of habitual behavior.

The Interpersonal Drives 

The interpersonal realm consists of one’s quality of social connection. As discussed in my article, The Impact of Isolation on Addiction, I shared Bruce Alexander’s famous Rat Park Study. He highlights how addiction is a disease of isolation, where substances are used to cope with isolation, producing even more isolation.

Researchers discovered how rats tended to overdose in the Rat Park Study when provided drugs while alone in a cage. These overdoses no longer occurred when rats were kept in the company of other rats.

Human beings are social creatures and isolation causes us deep emotional pain. Social isolation is an often overlooked health concern and recent research suggests it is as dangerous as smoking.

In a TED Talk, Robert Waldinger emphasizes the dangers of social isolation, stating:

“Loneliness kills. It’s as powerful as smoking or alcoholism.”

Physical health issues receive a great deal of attention, while interpersonal health is often neglected. Luckily, social determinates of health have gained traction in the scientific literature. Recent research looked at the impact of loneliness as a risk factor for mortality and found:

“Current evidence indicates that heightened risk for mortality from a lack of social relationships is greater than obesity.”

Coping with isolation through addictive substances or behavior is one-way social isolation can affect one’s physical health. For example, coming home from a stressful day to an empty home may result in coping through consuming alcohol.

Without addressing the underlying isolation and unmet social needs, one’s physical health may deteriorate as the short-term coping results in long-term harm. This can make it increasingly difficult to meet one’s underlying needs in a healthy way in the long-term.

Conclusion 

The neurological, cognitive, and interpersonal processes driving addiction are all intertwined. Although it is possible to analyze addiction on multiple levels, addiction is often experienced as a way to gain relief from an underlying source of pain, whether it’s past trauma, anxious thoughts, depressed moods, or the pain of social isolation.

If you want to learn more about the lived experience of addiction, I’ve written more on the topic in the article, What Does Addiction Feel Like?

If you want to learn more about the psychological factors driving addiction, check out my article, What are the Root Causes of Addiction?

As an addiction counselor, my approach to helping clients is based on recognizing these underlying factors. Recovery is the result of effectively turning toward the underlying pain in a self-compassionate way, uncovering core values, and building habits of committed action.

If you reside in Canada, I am currently taking clients for online counselling, in addition to in-person sessions for persons who live in the Windsor-Essex area. If you are interested in learning more, please complete the form below, and I will contact you for a free phone consultation.