by Steve Rose | Mar 22, 2020 | Addiction and Recovery, Suicide and Mental Health
In light of Covid-19, I’ve been thinking about the role of worry in our lives. As anxiety, uncertainty, and social isolation ramp up, we need to take care of our mental hygiene as well as our physical hygiene.
From panic shopping to media obsession, there is no shortage of worry going around. This new situation led me to become curious about how worry impacts our mental health.
Is worrying helpful?
Worrying can be helpful or harmful, depending on the type of worry. It is helpful when focused on practical short-term actions, but it is harmful when focused on abstract ideas about the future that lead to repetitive thoughts and inaction.
Let’s take a closer look at what this means and how you can keep your worrying in check.
What is Worry?
Researchers Kate Sweeny and Michael D. Dooley state:
“Worry is an aversive emotional experience that arises alongside repetitive unpleasant thoughts about the future.”
In simple language, worry is unpleasant emotions and thoughts about the future. These thoughts begin to act like a broken record, replaying the same lines over and over.
The emotion is usually fear, and the thoughts generally involve catastrophic scenarios—for example, a pervasive fear regarding the thought of potentially being infected by a virus.
Having this worry may be helpful, or it may be unhelpful, depending on the extent of the worry and the actions that follow. Let’s take a closer look at the research on helpful forms of worry.
Helpful Forms of Worry
A study titled The Surprising Upsides of Worry found that worrying acts as a motivator to take helpful precautionary measures. The researchers state:
“It also triggers efforts to mitigate the consequences of bad news, motivates productive behavior that in turn reduces worry, and enhances the effectiveness of goal‐directed action by prompting people to focus on obstacles that might derail best‐laid plans.”
People who worry more are more prepared and less likely to face risks in many areas of life.
A 2014 study found that people who worry more about skin cancer are more likely to wear sunscreen. A 2006 meta-analysis of the evidence found that women who are more worried about breast cancer are more likely to get screenings. Lastly, a 1990 study found that people who are more worried about getting an injury in an automobile accident are more likely to wear a seat belt.
In addition to motivating helpful preventative measures, worry can also act as an emotional buffer to adverse outcomes. This means you are less disappointed when things don’t go well. According to the researcher who conducted the study on the Upside of Worry:
“If people’s feelings of worry over a future outcome are sufficiently intense and unpleasant, their emotional response to the outcome they ultimately experience will seem more pleasurable in comparison to their previous, worried state…”
Worry lowers expectations about future outcomes, leading to better emotional states when things go better than expected.
Although worry has its benefits, it needs to be kept in check. Let’s take a closer look at the research on unhelpful forms of worry.
Unhelpful Forms of Worry
Unhelpful forms of worry are quite common and can cause an upward spiral of negative thoughts and uncomfortable emotions, leading to paralysis.
In an in-depth review titled, Constructive and Unconstructive Repetitive Thought, Edward R. Watkins states:
“…worry characterized by a concrete level of construal is constructive, whereas worry characterized by an abstract level of construal and negative intrapersonal context (e.g., low problem-solving confidence) is unconstructive.”
This finding means worry is productive when focused on practical actions and unproductive when worrying about large scale issues without a focus on concrete actions.
Unhelpful forms of worry are focused on repeatedly thinking about issues beyond your control. Since you cannot do anything about issues beyond your control, your mind pretends to be busy by worrying. Worrying feels productive when it is doing nothing to solve the problem.
Mary Schmich illustrates this when she states:
“…worrying is as effective as trying to solve an algebra equation by chewing bubble gum.”
Beyond not being useful, this type of worrying can be detrimental to your health, according to WebMD:
“Chronic worrying can affect your daily life so much that it may interfere with your appetite, lifestyle habits, relationships, sleep, and job performance. Many people who worry excessively are so anxiety-ridden that they seek relief in harmful lifestyle habits such as overeating, cigarette smoking, or using alcohol and drugs.”
When worry becomes pervasive and harmful to areas of your life, it may be helpful to consider whether you are using worrying as a way to feel busy. Although it gives the illusion of control, this type of worrying takes away your ability to take control.
When worry hijacks your brain, your fight or flight response turns on, reducing activity in the higher evolved prefrontal cortex, the area associated with control over one’s behavior. When worry spirals out of control, it leads to intense fear and paralysis.
In addition to limiting one’s ability to take practical actions to reduce the worry, it narrows one’s ability to move toward any valued directions in life.
Luckily, if you find yourself falling into this form of unhelpful worry, there are things you can do to regain balance.
How to Cope with Unhelpful Worry
As described in my previous article on How to Stop Living in Your Head, you can use the following to more effectively cope with unhelpful forms of worry:
- Accept what you can’t control
- Step back from your thoughts
- Focus on the present moment
- Remove limiting self-definitions
- Live by your core values
- Take action toward what matters
Take a look at the full article if you are interested in exploring each of these areas in-depth, in addition to learning some practical exercises designed to gain a healthy perspective.
Summary
Worrying can turn you into the slave of your thoughts and emotions. It can also motivate you to take necessary preventative action. Some worry is better than none, but too much worry can cause more harm.
Helpful forms of worry consist of short-term concrete actions, whereas unhelpful styles of worry include abstract catastrophic thinking leading to paralysis.
If you find yourself engaging in unhelpful forms of worry, it is also unhelpful for someone to simply tell you to stop worrying. If it were that easy, psychologists and addiction counselors would not exist.
by Steve Rose | Feb 13, 2020 | Addiction and Recovery
What is so appealing about regularly spending most of your paycheck at a casino or online gambling? Why do some people keep gambling, despite the increasing harm to themselves and others?
If you or a loved one suffers from gambling addiction, you may be wondering how someone’s gambling can get so out of control.
Working in problem gambling treatment and prevention, I’ve discovered some common features to help make sense of problem gambling.
How Does Gambling Addiction Work?
Gambling addiction works by hijacking the brain’s learning mechanism through random rewards.
This means you feel rewarded often enough to keep going, despite increasing losses. The idea of missing a potential win keeps the person focused on trying to get the money back. As you lose more, you begin to lose control.
At this point, gambling is no longer a form of entertainment. For some, it can feel like a job. For others, it becomes a way to escape from an increasingly stressful reality.
Gambling becomes both the problem and the solution. It is used to escape from stress in the short term while contributing to even more stress in the long term.
According to a 2006 study, the following variables are correlated with problem gambling:
…an early big win, the size of the win, boredom susceptibility, impulsivity, a poor understanding of random events, use of escape coping, stressful life experiences and depression.
In other words, gambling addiction works by keeping you locked into a pattern of behavior where you continuously expect to replicate an early big win, compounded by an illusion of control, all while allowing you to escape from boredom or stress. One or many of these factors may exist in someone struggling with their gambling.
Gambling is No longer Just Entertainment
Many people use gambling as a form of entertainment, similar to going out for dinner. You have a budget, expecting to spend a certain amount for the entertainment.
When gambling becomes problematic, it’s no longer about entertainment. It becomes a way to profit or escape.
Jodie shares her experience with an early big win in an article in BASIS:
“I obsessed over the machine I had been playing and won on. I thought if I could just get back to it – get back to the incredible high I felt – a high unlike any I had experienced before – get back to that moment of possibility as the reels spun around – things would be good, money would be easy, life would be better.”
Craig shares a similar experience in an article in The Guardian:
“Gambling for me wasn’t about chasing the big win, it was about chasing the money I’d already lost”
Others primarily use gambling as a way to escape. 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, is 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 can come at a long term cost once the harms begin to exceed the entertainment value.
Gambling Changes the Brain
Problematic gambling changes the reward pathway in the brain, causing you to lose control over the behavior. Dopamine is produced when you encounter a favorable situation, rewarding you so that you can learn from the positive event and try to repeat it in the future.
This dopamine response is a useful learning mechanism if you are practicing a skill such as shooting basketballs into a net. Each time you get closer, your brain rewards you, reinforcing more skillful actions.
Our brains evolved to seek out patterns. Finding patterns helped us evolve as human beings. Consider the thousands of years of early human learning as hunter-gatherers. Recognizing weather patterns, animal behavior, and types of plants allowed early humans to survive and evolve.
In the case of gambling, this learning mechanism is hijacked by randomness. No patterns exist in a state of randomness, but we naturally try to find them anyway. The intermittent rewards trick the brain, continuously causing a dopamine response to near-misses, urging you to try again.
Though unlike basketball practice, there are no patterns and you have no control over the outcomes. Even if you know this consciously, your brain’s deeply entrenched learning mechanism continues urging you forward anyway.
As a participant shares in a 2017 study:
When you have a gambling problem, it’s the same as if you used heroin, or something else. Like, you don’t think anything else but where can you get more money. (Male, 34)
Even though gambling doesn’t require ingesting chemical substances, it produces the same dopamine response as any drug.
It’s Not Necessarily About the Money
As you can probably tell by now, gambling addiction is about much more than greed. Gambling is both a form of escapism and a source of thrill.
Going one step deeper, gambling is also often used to meet basic human needs. The basic human need for belonging particularly stands out.
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 common household items like pots and pans.
Casino’s have a culture of their own, constantly facilitating a sense of specialness. For those who are socially isolated or suffer from low self-esteem, the casino marketing machine can artificially meet this need.
Summary
Gambling addiction works by hijacking the brain’s learning mechanism through random rewards.
As the harms outweigh the entertainment value, a person loses control over the behavior and becomes fixated on winning back losses.
Gambling can be a source of thrill or a form of escape from stressful life events. As gambling is used as an escape in the short term, it contributes to further problems in the long term.
Gambling addiction is not necessarily about money. Rather, it is often a form of escape, in addition to a way to fulfil an unmet need for self-esteem or belonging.
Although gambling addiction has several unique features on the surface, it functions like any other addiction. To learn more about the underlying processes in addiction, check out my article, What are the Root Causes of Addiction?
To learn more about my approach to addressing these underlying issues, check out my article How to Improve Psychological Flexibility. In that article, I delve into the six processes of Acceptance and Commitment Therapy (ACT), sharing my favourite therapeutic metaphors and exercises.
Want some practical tips on how to control your gambling? Check out my new article, 7 Ways to Stop Gambling and Save Money.
If you are looking for specialized support, click here to learn more about my online services.
by Steve Rose | Oct 22, 2019 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
As smartphones take over the world, you may find yourself asking, “am I addicted to my phone?”
Whenever I tell someone I treat internet addiction, they commonly mention how often young people are using their phones at the exclusion of face to face interaction. They often have a few people in mind or share that they themselves are probably addicted to their phone.
Although it may feel like we are always on our phones these days, the word “addiction” should not be taken lightly.
The key thing I’ve learned in my experience helping people with technological addictions is that the amount of time someone spends on their phone does not necessarily mean they have an addiction.
The distinguishing factor between a healthy and unhealthy relationship to your phone is the amount of control you have over your usage and the impact it has on your life.
You may use your phone often and have a healthy relationship to your phone if you have control over its use and it does not cause disruptions in your life.
If you have an unhealthy relationship to your phone, you often lose control of your usage and it begins to cause disruptions in your daily life.
If you want to find out if you are addicted to your phone, take the quiz below.
*This quiz is based on the Internet Addiction Test (IAT) (K.Young, 1998). Although the IAT is used as a valid psychometric in the internet addiction field, this quiz is not meant to serve as a formal diagnosis.
Let’s take a closer look at each component in the assessment.
Are you preoccupied with your phone?
Beyond simply using your phone frequently, addiction requires you to feel constantly preoccupied with your phone.
This means you often think of your phone when you are not on it, anticipating when you will be able to use it again.
It could also involve frequently checking your phone before you do any activity, and perhaps several times during an activity. This constant fear of missing out leads to an inability to focus for a length of time without feeling the need to check your phone.
Are you using your phone to escape?
Just like an addiction to any substance, an unhealthy relationship to your phone involves using it to escape from difficult thoughts or emotions.
This means you may often turn to your phone to avoid difficult situations. Perhaps it may be a way to avoid social anxiety, or a way to block out uncomfortable feelings rather than dealing with issues directly.
A small bit of escapism may be healthy if used in moderation as a form of entertainment. Unhealthy escapism results in short term relief at a long term cost. Perhaps turning to your phone every time you feel uncomfortable may temporarily reduce the discomfort, but in the long run, it reinforces issues and begins to affect other areas of your life.
Is your phone use affecting your relationships or opportunities?
Just like any addiction, chronic phone use can begin to affect your relationships and other areas of your life.
This may involve people becoming concerned about the amount of time you spend on your phone. You begin to isolate and turn down opportunities to spend time with friends and family. Perhaps you may spend time on your phone at the expense of intimacy in your romantic relationships.
This may also affect other areas of your life as well, limiting opportunities for progress toward valued goals. This is particularly relevant if your phone use is significantly affecting your focus at work.
In addition, if you are losing sleep due to your phone use, you may not be functioning optimally during the day, affecting your mood and cognitive performance.
Are you lying about your phone use?
As is common with any addiction, lying to cover the extent of your use may signal an unhealthy relationship with your phone.
This may involve becoming defensive or secretive about your phone use. Perhaps someone is concerned about the increasing time spent on your phone and decides to voice these concerns. If you begin to feel a sense of disapproval from others, you may feel tempted to hide your usage to prevent future negative reactions.
This can further contribute to isolation, putting an even greater strain on close relationships.
Are you staying on your phone longer than intended?
Like gambling on a slot machine, it is easy to lose track of time while on your phone. Even though your phone has a clock on it, you may often get lost scrolling through endless feeds.
This can often result in late nights surfing, chatting, or scrolling, affecting your sleep. Although this is common, the amount it affects your daily life would determine how much of an issue it is for you.
Do you need to spend increasing amounts of time on your phone?
Just like any substance, tolerance develops with increasing use. When the thrill wears off, increased use is required to achieve the same effect. Eventually, it may not even be satisfying, simply being required to avoid the pain of discontinuing use.
This results in prolonging the time spent on one’s phone over time. Although the amount of time spent on one’s phone can affect other areas of life, it is not an indicator of an unhealthy relationship with your phone on its own.
Do you often make unsuccessful attempts to cut down on your phone use?
Perhaps you’ve recognized you have an unhealthy relationship with your phone and have decided to cut down on your usage. Multiple unsuccessful attempts to control your usage perhaps signals diminished control, an aspect of any addiction.
Gaining back control over your phone use requires more than simply trying harder. It requires seeking support and working through the underlying issues.
Are you using your phone to escape from difficult situations or emotions? What does your phone offer you that is missing in your everyday life? How can you begin confronting difficult situations, working with difficult emotions, and take back a sense of control over your technology use.
Conclusion
Many people think they are addicted to their phones because of the amount of time they spend on them. As discussed, this is not a reliable way to measure addiction.
As the world becomes increasingly virtual, constant use of digital technology is becoming the norm. Rather than looking at what you use, it is helpful to consider how you use it.
Addiction to your phone involves decreased control over your use and negative impacts on other areas of your life.
Specifically, it involves a sense of constant preoccupation, a negative effect on relationships or career opportunities, lying about your usage, using your phone longer than intended, needing to spend increasing amounts of time on your phone, and making several unsuccessful attempts to stop.
by Steve Rose | Sep 22, 2019 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
Each video game is addictive for different reasons. Also, each person may find different elements of a game addictive. Although every case is unique, there are general patterns that can help explain why video games are addictive.
Video games are addictive because they help meet our basic psychological need for a sense of freedom, purpose/progress, and social connection.
Let’s take a closer look at each of these factors.
Video games offer a sense of freedom
Video games can be addictive because they offer a high degree of freedom that is unparalleled outside gaming environments. Let’s take a look at a few ways video games facilitate a sense of freedom.
Video games allow you to escape from social constraints.
From fantasy science fiction worlds to realistic combat environments, games allow a person to escape from the normal constraints of the offline world. This is especially relevant for someone struggling with social anxiety.
Offline social interaction can be challenging for individuals who find social situations anxiety-provoking, confusing, or over-stimulating. Games offer an escape from the constraints of social anxiety, providing a sense of freedom and control.
Although games serve as a short-term escape, avoiding in-person social situations comes at a long-term cost. Rather than facing one’s fears and dealing with the anxiety, games offer virtual freedom while keeping an individual dependent on the game as a form of escapism. Using games to avoid difficult emotions can lead to increased use over time, making in-person interaction even more difficult.
Video games allow you to experiment with different identities.
By experimenting with one’s personal gaming avatar, games offer the chance to try out new identities instantly, without the long-term social implications of the offline world.
This can be especially engaging for individuals who are dissatisfied with their offline identity, suffer from low self-esteem, or feel they cannot express certain aspects of their identity in their offline social context.
Identity experimentation through games can be healthy and liberating, but it can also be detrimental to developing one’s offline identity and sense of self-esteem. This is especially relevant if games serve as a form of escape or way to avoid confronting deeper self-esteem issues.
Video games offer a sense of adventure.
Games offer the infinite ability to explore new worlds. For those high in novelty-seeking, gaming environments offer a high level of exploration and experimentation without the dangers present in the offline world.
The modern world can often seem mundane, especially if you are bored and dissatisfied in your work or schooling. Gaming environments offer a way out of this monotony of everyday life and can be addictive because of the infinite possibilities they present.
Video games offer a sense of purpose
Video games can be addictive because they offer a strong sense of mission and purpose. Let’s take a closer look at how games offer a sense of purpose.
Video games facilitate a sense of progress through leveling up.
Games offer a sense of progress through their mission orientation. In addition, players gain a sense of mastery when their skills improve. This mission orientation and skill improvement are symbolized by character development, resource acquisition, leveling up to new environments, and various point systems.
This sense of progression can be especially rewarding for someone who feels like they are in a rut in their offline life. Games offer a way to meet our basic need to feel like we are progressing, even if it is virtual.
Another addictive feature common in games is their variable-ratio reward schedule. Like slot machines, games are designed with features that randomly reward players, keeping them hooked on a sense of anticipation. Loot boxes are a common form of this reward structure.
Video games with no defined end encourage infinite play.
Games with no defined endpoint encourage long-term investment. This can be addictive because the more time and energy one invests into an activity, the more difficult it is for them to simply abandon all of their efforts.
In addition, long-term play with a specific avatar builds a sense of identity investment, making it more difficult to let go.
Also, games with no defined end-point also encourage longer gaming sessions. This is the gaming equivalent of a Netflix binge. Gaming can continue indefinitely, potentially causing further isolation from one’s offline world.
Video games facilitate a flow state.
Flow states are moments you feel completely immersed in an activity. This is also referred to as being “in the zone”. You may lose track of time, feeling a sense of energized focus. Flow states are common when you are engaged in an activity that is challenging but not too difficult.
Video games are designed to facilitate a flow state, challenging players enough to keep them engaged, but not too challenging, encouraging a sense of purpose through progress.
The sense of purpose obtained through games is comparable to the sense of purpose obtained outside gaming. When games begin to be the primary means of meeting this need for a sense of purpose and progress, life outside gaming may seem less appealing.
Video games are addictive because they offer an easier way to meet this need, without the risks of working to meet this need outside of a gaming environment.
Video games offer a sense of connection
A fundamental human need is a sense of connection. We are social beings and can easily fall into a sense of despair when feeling isolated. Internet gaming allows players to meet this need in an interactive online gaming environment.
Video games can bond you with a team of individuals.
Many online multiplayer games involve teams of individuals. Cooperating with a team bonds individuals toward a common goal. This taps into our innate drive to connect with something larger than ourselves. This can also lead to a fear of missing out and a sense of obligation to play, feeling depended on by the other players on a team.
Video games connect you with a grand narrative.
Connecting with something beyond ourselves may also include connecting with a narrative. Even in games without other online players, gaming narratives connect an individual to a story and virtual characters. Like reading a good novel, players become immersed in the story, making it difficult to simply walk away from.
Video games connect you with like-minded persons.
Connecting with like-minded individuals makes us feel like we are not alone, meeting our need for a sense of connection. Online games connect players with common interests. This is especially relevant if one feels isolated in their offline environment.
Games can meet our need for a sense of connection, but when gaming becomes an addiction, they reduce one’s ability to meet these needs offline, reinforcing the need for continued play.
What is video game addiction?
In 2018, the World Health Organization classified Gaming disorder as an official form of addictive behavior. It consists of three components:
- The loss of control over one’s gaming
- Gaming taking priority over other areas of life
- Continued use despite negative consequences and impaired functioning in other areas of one’s life.
The key difference between someone who has a video gaming addiction and someone who plays a lot of games is the lack of control and the negative impact it has on the person’s life. This negative impact can include dropping out of schooling, loss of employment, loss of contact with in-person friends, or family, in addition to physical health issues.
Conclusion
Video games are addictive because they can meet our basic psychological need for a sense of freedom, purpose/progress, and social connection.
Video games provide an environment to experience a sense of freedom from social constraints, social anxiety and allow for a sense of adventure.
Video games also provide a sense of purpose and progress through a mission orientation and the ability to level up.
Lastly, video games provide a platform for individuals to gain a sense of social connection with like-minded individuals.
When these needs are unmet in one’s offline environment, games can be used to meet these needs virtually. Meeting one’s needs through games at the expense of meeting them in non-gaming environments further reinforces the appeal of gaming, making it continuously more difficult to meet these needs offline.
by Steve Rose | Jun 19, 2019 | Addiction and Recovery
On the go? Listen to the audio version of the article here:
In recent years, the recovery model, or recovery approach, has become widely popular in addiction and mental health treatment systems. This shift has come as part of a broader social movement away from long-term institutionalization of persons with addictions or mental health issues.
I thought I would summarize what I’ve recently learned about the recovery model since I’ve been coming across it more frequently lately in the health care setting. I believe the recovery model is changing the way addiction is dealt with and hope that its principles continue to become widely adopted in the field.
What Is The Recovery Model?
According to The Substance Abuse and Mental Health Services Administration,
“Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.”
This means treatment is focused on empowering people to support their own self-directed path of recovery. In doing so, the person is supported so they can reach their full potential.
This approach is distinct from authoritarian approaches to treatment whereby the individual is prescribed a rigid path of recovery, in addition to a narrow definition of what a successful recovery means.
Supporting someone with an addiction based on a recovery approach involves four components:
Health: The person’s health is considered by managing any diseases and supporting activities that allow them to physically and emotionally flourish.
Home: The person’s sense of safety and security is considered, supporting their sense of a stable place of residence.
Purpose: The person’s sense of purpose is considered, supporting their sense of meaning and contribution to their broader social context.
Community: The person’s sense of community is considered, supporting their sense of belonging and social connection.
What Are The Guiding Principles of Recovery?
According to the SAMHSA, there are ten guiding principles of recovery:
1. Recovery is person-driven. This means allowing the person to drive their own recovery, including defining their personal goals for recovery. It means supporting their autonomy, allowing them to take action without coercion or manipulation.
2. Recovery is supported by addressing trauma. This means understanding addiction as a common response to coping with traumatic events in one’s life. Creating a safe, non-judgmental environment allows the person to feel comfortable sharing these underlying issues.
3. Recovery emerges from hope. This means supporting hope by helping the person break down their long-term recovery goals into short-term manageable ones, making the process seem more realistic and clear.
4. Recovery is based on respect. This means maintaining an attitude of respect toward the person without the attitude of judgment or blame that can further stigmatize the individual, driving them into further isolation.
5. Recovery is culturally based and influenced. This means considering the person’s culture in supporting their treatment. It also means adopting their own understanding of their culture rather than your own predetermined idea of it.
6. Recovery is holistic. This means considering the biological, psychological, and social forces involved in recovery, supporting healthy development in each of these domains.
7. Recovery occurs via many pathways. This means there are multiple paths to recovery, and each person needs to be supported in their own path, whether it involves abstinence-based practices or harm reduction. Also, various therapeutic styles need to be considered since no one method is appropriate for every person.
8. Recovery is supported by peers and allies. This means recognizing the role of peers who are in various stages of their own recovery from similar issues. The recovery model makes the distinction between experts by profession and experts by experience. Both are considered valuable.
9. Recovery is supported through relationship and social networks. This means recognizing the power of social connection, considering ways to support the person by facilitating further social ties to develop a sense of belonging.
10. Recovery involves individual, family & community strengths & responsibilities. This involves supporting the person in their social roles, allowing them to maintain a sense of purpose through family connections or contribution to a broader community.
Does The Recovery Model Work?
Research on the recovery model supports its effectiveness. According to a 2010 study on treatments for Schizophrenia:
“A growing body of research supports the concept that empowerment is an important component of the recovery process and that user-driven services and a focus on reducing internalised stigma are valuable in empowering the person with schizophrenia and improving the outcome from illness.”
According to a Systematic Review on the recovery model:
“The recovery processes that have the most proximal relevance to clinical research and practice are: connectedness; hope and optimism about the future; identity;
meaning in life; and empowerment (giving the acronym CHIME)”
The recovery model is distinct from models of addiction treatment based on confrontation and strict authoritarian control. Approaches based on confrontation have been largely discredited and are often harmful.
According to the book, Treating Addiction: A Guide for Professionals:
“The American detour into a denial-busting confrontational style for addiction treatment was, from our perspective, an aberrant wrong turn justifying treatment practices that would be blatantly unprofessional and unethical in any other area of health care, and clinical trials of such approaches have yielded uniformly negative results”
The recovery model is an effective approach to addiction treatment because it fosters a person’s internal locus of control, intrinsic motivation, and a sense of self-efficacy.
An internal locus of control means a person has the sense that they are in control of their life. This is important because someone suffering from an addiction is experiencing the complete opposite. Addiction can enslave someone, taking away their sense of control.
The principle of person-driven recovery places responsibility on the other person for their recovery, allowing them to practice taking control over their life. An internal locus of control develops as a byproduct of rising to the occasion and noticing the small wins.
The recovery approach also develops a person’s sense of intrinsic motivation. This is the most powerful form of motivation. It is a person’s deep internal drive, distinct from extrinsic motivation, which is only based on a person’s desire for an external reward or to avoid punishment.
Trying to make someone change through manipulative rewards or punishments may work, but the result is often temporary. Once the external force is removed, the person resumes old habits. The person-driven principle in the recovery approach fosters this internal drive for recovery, leading to long term success.
The recovery approach is also effective because it develops a sense of self-efficacy. This is the sense that you can achieve success, as opposed to the sense that you are helpless. Someone suffering from addiction may often experience a sense of helplessness when it comes to recovery.
The person-driven approach combats a sense of hopelessness and helplessness by empowering the person to actively direct their recovery, allowing them to gain a sense of accomplishment along the way, building their trust in their own capacities.
How Do You Implement The Recovery Model?
All of this probably sounds pretty good, but you may be wondering how you actually do a recovery approach. The recovery model is fairly abstract and philosophical, but it is meant to be guiding spirit for existing treatment tools and techniques, not a treatment method on its own.
In other words, the recovery model is a broad overall approach to compassionate person to person relationships and can be applied through Evidence-Based Practices in addiction treatment.
The evidence-based technique of Motivational Interviewing is highly compatible with the recovery model in addiction treatment. The spirit of motivational interviewing is deeply aligned with a recovery approach. As stated by its founders:
“Motivational interviewing is a way of being with a client, not just a set of techniques for doing counseling.”
On a technical level, it involves engaging the person through active listening, asking open-ended questions, encouraging them to talk about their desired goals, and collaborating with the person to support them as they begin taking action toward these goals.
I discuss specific techniques adopted from the motivational interviewing literature in my article, “The Ultimate Guide to Helping Someone Change.”
For a detailed tutorial of motivational interviewing techniques, I highly recommend doing the free online modules hosted by the British Medical Journal: Motivational interviewing in brief consultations.
Conclusion
The recovery model has been transforming addiction and mental health treatment, offering a more effective and humane approach to working with persons who are interested in improving the quality of their lives.
It recognizes the value of overall health, a stable home, a sense of purpose, and a sense of community belonging and support.
If you’re interested in reading more on this topic, I’ve recently written an article, “How to Help Someone With an Addiction,” describing a recovery approach to supporting a loved one or a client. It is applicable for non-professionals and professionals working in the field.
If you are interested in obtaining professional training in the recovery model in addiction, you can sign up for the NAADAC Recovery to Practice (RTP) Certificate Program.
by Steve Rose | Jun 17, 2019 | Addiction and Recovery
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In 2018, the World Health Organization classified Gaming disorder as an official form of addictive behavior. It consists of three components:
- The loss of control over one’s gaming
- Gaming taking priority over other areas of life
- Continued use despite harmful consequences and impaired functioning in other areas of one’s life.
In my work with persons addicted to gaming, I’ve noticed a few common factors contributing to this issue.
By considering the reasons why people become addicted to games, we can gain insight into how to prevent gaming addiction before it starts.
So how do you prevent a gaming addiction?
Develop a sense of self-esteem, social belonging, and purpose. Gaming addiction develops as a way to meet these basic needs. Meeting these needs outside of a gaming environment will reduce your risk of developing a dependency.
Let’s look at what the research says about each of these basic needs and how you can reduce your risk of a gaming addiction by strengthening each of these areas.
Develop a Healthy Sense of Self Esteem
According to a 2005 study, online games provide an environment for persons with low self-esteem to escape, allowing them to feel more confident. A more recent 2018 study finds the same correlation, focusing on the link between low self-esteem and risk of internet addiction.
Developing a healthy sense of self-esteem may sound like a cliché baby-boomer parenting strategy, marked by participation robbins and positive affirmations about how great we all are, but this is not what I mean by self-esteem boosting.
A 2003 study already debunked the idea that boosting self-esteem improves performance and life satisfaction. The point is not to boost self-esteem by cheerleading ourselves and our children. Instead, self-esteem begins to rise as we take action toward meaningful goals, improving our skills and abilities.
In a gaming environment, success is a quick fix. Like any form of addiction, it is a short-term solution to a long-term problem.
If experiencing low self-esteem, games can offer a temporary experience of leveling up and gaining skills. Unfortunately, these experiences are limited to the gaming world. Once outside the game, your self-esteem remains the same, going down slightly over time as you begin to neglect your offline life.
To prevent a gaming addiction, it is important to consider small ways to gain success in the offline world. Here are a few potential areas of development:
- Maintain a clean and organized personal environment.
- Pick up a new skill or hobby.
- Read books (I like audiobooks, personally).
- Consider advancing your formal education.
- Take small steps to advance your career.
Anything that gives you a sense of growth allows you to build self-esteem, lowering the risk of needing to seek it in a gaming environment.
Self-esteem comes from seeing the result of your actions, not from falsely telling yourself how great you are. This requires changing your relationship with yourself, considering the ways your thoughts or anxieties may be blocking further growth.
If you want to learn more about how to have a productive relationship with yourself, I highly recommend checking out The Confidence Gap: A Guide to Overcoming Fear and Self-Doubt by Russ Harris.
Develop Strong Social Connections
The power of social connection is a key theme throughout all of my work. Social isolation is just as detrimental to your health as smoking, according to research.
Human beings are social creatures, so if we feel isolated or are isolating ourselves due to shame or anxiety, we may find creative ways to meet this social need. Online gaming may be one way to meet our social need for a sense of belonging and connection with others.
It can be healthy to connect with others in gaming environments if it is balanced with offline social activities. When gaming begins to negatively affect offline relationships, it might be time to reconsider ways to repair and maintain our offline relationships to prevent further harm.
A 2011 study on the psychosocial causes and consequences of pathological gaming found that “lower psychosocial well-being is more likely to be a cause than a consequence of pathological gaming.” This confirms the fact that maintaining healthy relationships is a preventative factor for gaming addiction.
So how can you maintain healthy offline relationships?
- Consider joining a local club or meetup group (Check out the Meetup App)
- Dedicate at least one day a week to meaningfully connect with parents, relatives, or close friends, in person.
- Regularly engage coworkers or acquaintances in small-talk about their own interests or recent events.
My article on How to Spend Less Time on Social Media may also be helpful if you want specific strategies tailored to a social media environment.
By fostering and maintaining strong offline social relationships, online gaming can serve as a supplemental form of entertainment and connection rather than a way to cope with isolation in an all-consuming way.
Online relationships in gaming environments can be beneficial and deeply rewarding, sometimes even turning into in-person relationships. The power of these relationships should not be discounted.
The goal of preventing a gaming addiction is to consider its impact on your life. If gaming is balanced and adding to your offline life, then it may be healthy. If it is taking away from your offline life, it may be helpful to reconsider the balance.
Working to develop offline social connections is one way to help meet our social needs, reducing the risk of a gaming addiction.
If social anxiety is preventing you from reaching out and connecting with others, I again recommend The Confidence Gap: A Guide to Overcoming Fear and Self-Doubt by Russ Harris (…no, I am not getting paid for this recommendation. I just love the book!).
Develop a Sense of Purpose
Without a sense of purpose, life can become unbearable. Floating around in a directionless haze is its own unique form of torture.
As human beings, we are built to pursue goals. The dopamine systems in our brains are made for this purpose. In the absence of meaningful goals, gaming can fill this void, offering a sense of purpose through elaborate missions or storylines.
Although it can be entertaining to play games, for this reason, we need to recognize when the online world is becoming a substitute for a sense of purpose in our offline world.
So what is the antidote to offline purposelessness?
Make yourself useful!
In theory, it sounds easy. It’s not too hard to find someone needing help. The problem is that you can’t be useful to anyone else if you’re not useful to yourself first.
The key is that your way of contributing fits your unique personal strengths.
Misalignment between your strengths, values, and interests can hinder your level of usefulness and the resulting level of purpose you feel toward the role. Finding alignment between your abilities and your role requires first knowing your strengths and cultivating them.
If you want to delve way more in-depth into this topic, you can check out my comprehensive article: What Does It Mean to Have a Purpose?
Developing a sense of purpose in our offline worlds can help reduce the risk of a gaming addiction by filling this basic human need to strive for something beyond ourselves.
Conclusion
Gaming is not necessarily the problem. It is often used as a solution to an underlying problem. When our needs are not being met in our offline world, gaming is one way to meet these needs.
When gaming becomes an addiction, things outside the gaming environment begin not to matter. Self-esteem goes down, relationships suffer, and our non-gaming lives lose a sense of purpose.
Although games are used to cope with the lack of these needs being met, a gaming addiction takes a person further away from being able to meet these needs outside of gaming. The unmet needs lead to more gaming, and more gaming leads to further unmet needs.
To prevent a gaming addiction, it is important to develop a sense of self-esteem, social belonging, and purpose.
If you or a loved one is struggling with a gaming addiction, you may find it helpful to check out Game Quitters. It is a comprehensive resource designed to support gamers and loved ones.
You can also check out my recent article on How to Help Someone With an Addiction for general insights on how to maintain a productive helping relationship with the person you are supporting.
