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Do you find yourself constantly overthinking? Does life feel overwhelming?
You may struggle with constant thoughts of “what if…” keeping you up at night. Mentally preparing yourself for the worst-case scenario, there’s a constant sense of tension in the background.
Sometimes you feel like you’ll explode, while other times, you believe your worrying is the only thing keeping everything together.
Focused on keeping things together, you’re unable to live the life you want. Deep down, you know you could be so much more focused, joyful, and free, if only the alarm bells in your mind could stop ringing all the time.
In this article, I will discuss how you can stop overthinking so you can take a breath, relax, gain inner peace, and refocus on living a joyful life of meaning and purpose.
So how do you stop overthinking and start living?
Change your relationship to uncertainty
Notice what is happing in the present moment
Act in alignment with your values
In short, this means being open, aware, and engaged.
These three characteristics are the foundation of psychological flexibility, the core feature of Acceptance and Commitment Therapy (ACT), supported by over 330 clinical trials.
Many people try to stop overthinking through positive thinking, focusing on the breath, or through distractions. These can be helpful sometimes, but often produce limited results in the long-term because they don’t target the underlying issue.
As a counselor, I’ve seen huge results using the principles I share in this article. Noticing the power of these principles in my one-on-one work with clients, I’ve been inspired to make these ideas more accessible to a broader audience.
Let’s take a closer look at how you can apply these techniques in your own life so you can stop overthinking and start living.
Table of Contents
Change your relationship to uncertainty
As described in my previous article on addiction to overthinking, many people consider overthinking to be a strength. As an academic, I can relate to this sentiment, but I also believe it is important to distinguish overthinking from critical thinking.
Overthinking is closed, rigid, and based on fear. It is generally unproductive and results in analysis paralysis.
Critical thinking is open, flexible, and based on curiosity. It is generally productive and results in useful information about how to proceed.
Overthinking thrives on closeness and rigidity. If we try to give the overthinking mind a false sense of certainty, it only wants more. Like giving money to someone with a gambling addiction, it only fuels its insatiable apatite.
If you’ve ever tried to stop overthinking by getting reassurance, you may be able to relate. Like an addiction, it offers short-term relief at a long-term cost.
Treating overthinking like an addiction, the problem is not thinking. The problem is your relationship to thinking. Like addiction, the problem is not the specific drug or addictive behavior. Alcohol or gambling can be used as entertainment, or they can be used to cope with underlying issues.
The problem is not the substance or addictive behavior. The problem is one’s type of relationship to that specific substance or behavior.
Telling someone to “just stop overthinking” is like telling someone with an addiction to “just stop being addicted.” Although well-intentioned, it does not address the fact that the person relates to the addictive substance or behavior to cope with underlying issues.
Are you using overthinking as a way to cope with an underlying avoidance of uncertainty?
If so, consider how it can feel productive, as if running through all of the “what if” scenarios will finally result in certainty.
What thoughts generally run through your head? What situation beyond your control is your mind trying to generate certainty for?
What is your mind telling you about the worst-case scenario?
At this point, it would be common sense to ask you to weigh the evidence for and against this worst-case scenario, but it would probably just result in another form of short-term reassurance at a long-term cost.
In the counterintuitive world of psychology, common sense is often a stumbling block.
Logic and reason become a different form of overthinking in disguise. They may give temporary relief, only fueling the underlying avoidance of uncertainty.
Trying to eliminate uncertainty through logic and reason often results in feeding the overthinking mind fresh meat. It comes back roaring with alternative scenarios trying to convince you that you’re wrong.
A tiger metaphor by Steven Hayes, the founder of Acceptance and Commitment Therapy (ACT), seems fitting here.
Imagine you adopted a cute young tiger cub. It wanders through your home like a kitten, and you begin to notice it won’t stop purring loudly. The only way you can make it stop is to feed it red meat. Over the months and years, you keep doing this, but the tiger is now several hundred pounds, requiring whole sides of beef to feed its insatiable hunger. Rather than a cute purr, the tiger roars ferociously for its meat. You are terrified, so you keep giving him the meat so he will leave you alone. The more you feed it, the larger it gets, and the more trapped you become.
In this metaphor, feeding the tiger symbolizes overthinking. Constantly feeding your mind analysis and “what if” scenarios feel like you’re giving it what it needs, but in reality, the problem grows because you’re not addressing the underlying issue.
The underlying issue is the infinite desire for certainty.
Like trying to recover from a gambling addiction by winning a jackpot, there is no endpoint in the search for certainty.
The first step to recovering from overthinking requires giving up on this infinite game.
In practical terms, this means accepting uncertainty and letting go of things outside of your control. For example, choose a specific “what if” such as, “what if I run out of money and lose everything.” A common thought pattern might be overthinking all the various ways things might go wrong, then beating yourself up, and feeling ashamed.
Making peace with uncertainty means answering the “what if” with “maybe yes, maybe no.” Then, you can move forward and focus on what you can control.
Back to the example, your mind says, “… you’ll lose everything”. You can thank your mind for trying to keep you safe and gently answer, “maybe yes, maybe no, but your constant reminders are not helpful right now, so I’m just going to go over here and do this other thing right now.”
Whatever you choose to focus on can be related to the concern, but if there is nothing you can directly control right now, it means focusing on something that matters to you. We’ll discuss this more in the final section of the article.
The first step in the process is to open up to uncertainty. Although living with a big question mark hanging over your head is uncomfortable, like exercise, a healthy dose of discomfort can go a long way.
“Learning to sit with ambiguity can be a very important start at a life liberated from anxiety—and the way to do it is to resist the urge to chase answers to questions that may actually be unanswerable.”
Notice the title of his book, “things might go terribly horribly wrong.” This is the opposite of a friend’s well-intentioned reassurance, but it is also not meant to be all doom and gloom.
Just because things might go terribly horribly wrong does not mean they will. Not accepting the fact that things might go wrong makes your problem-solving mind go into overdrive. By overthinking all the ways things might go wrong, your mind tries to gain certainty that things will work out.
Although problem-solving can be productive in many areas of life, it is unproductive to seek certainty regarding things outside your control. Rather than contributing to practical next steps, it takes your attention away from potentially more worthwhile endeavors.
Notice what is happing in the present moment
When the problem-solving mind goes into overdrive, it seeks certainty in an uncertain future. Thoughts beginning with “what if” point to potential future catastrophes.
This fixation on the future is like driving with your eyes glued to the GPS overview of your route. It can be helpful to glance at the GPS every once and a while but overthinking leads to neglecting the present. While your problem-solving mind is trying to figure out if there will be traffic holdups at some point on your journey, you miss the stop sign right in front of you.
We can easily recognize how too much of a future orientation can lead to dangerous driving, but we often neglect how it affects our daily lives.
“If you are depressed, you are living in the past. If you are anxious, you are living in the future. If you are at peace, you are living in the present.”
Although you may recognize the importance of living in the present, you may be put off by practices such as meditation and breathing exercises. These approaches can be effective but are often too advanced for people who are struggling the most.
For example, if someone has ADHD or intense anxiety, jumping into meditation can have the opposite of the intended effect. This phenomenon is called relaxation-induced anxiety. On the cognitive level, it goes something like this:
Meditation instructor: “okay.. now bring your attention to the breath.”
You: “oh no, my chest feels tight… am I breathing too fast?”
Meditation instructor: “…and with each breath, you feel more relaxed.”
You: “I’m so tense… I must be doing it wrong.”
Meditation instructor: “Notice the rise and fall of your chest.”
You: “AHHH!.. It’s getting worse! Now my heart is racing!”
To avoid relaxation-induced anxiety, I generally introduce mindfulness as something distinct from meditation.
Jon Kabat-Zinn, founder of mindfulness-based stress reduction (MBSR), defines mindfulness as the following:
“…the awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally.”
Notice how there is no mention of “relaxation” in this definition. It simply refers to paying attention to the here and now without the extra mental chatter casting constant judgments on the situation.
A practical way to pop yourself out of your head and into the present is called “grounding.” Although there are slight variations between different grounding techniques, here is a common simplified one I like to use:
Take a moment to notice some things you can see around you.
You might notice the shape, color, texture, and arrangement of the objects.
Next, bring your awareness to the things you can hear right now.
You might notice the various layers of sound: a fan humming, birds chirping, people talking.
Next, bring your awareness to the feelings in your body.
You may notice the feeling of the chair, your feet on the floor, or any tension in your jaw, hands, or shoulders/ neck.
Keeping this as simple as possible takes away the rigidness, complexity, and expectations people generally falsely associate with these types of practices.
For people who have difficulty sitting still, this can be done while walking, cleaning, waiting in line, or any other daily activity where you frequently find yourself getting stuck in your head.
This takes the practice of mindfulness off of the meditation pillow and into everyday life. It also opens up mindfulness practice to those who shudder at the idea of sitting still in silence for ten minutes.
If you are interested in trying some simple meditation practices, many people find it easier to start with guided meditation. You can check out headspace or some great guided meditations on youtube here and here.
Act in alignment with your values
Analysis paralysis is one of the biggest ways overthinking stops you from living the life you want. Stuck in your head, searching for certainty before you act, your overthinking mind is trying to protect you from disappointment while keeping you locked into old ineffective patterns.
In its search for certainty, your mind becomes perfectionistic. You put off actions that push you outside the realm of the familiar. It’s as if your mind wants to make sure you’re completely prepared before making any change, saving you from any potential failure.
“What if I try and it all goes wrong… what would that mean about me as a person?”
The fear of failure is just as strong as the fear of success.
“What if I succeed and I can’t handle the pressure… everyone will find out I’m an imposter.”
You may self-sabotage, preferring the comfort and certainty of sameness over the uncertainty that comes with change. Self-sabotage gives a false sense of control. Rather than making yourself vulnerable to someone else letting you down, we can feel like masters of our fate, even if it means our own demise.
Choosing to act also comes with heightened expectations for yourself. Since there is no certainty that it will work out, choosing to act makes you vulnerable to your inner critic if things don’t work out.
Maybe you’ve experienced situations in the past where you’ve hoped to achieve something and have been let down. This sense of disappointment can stick with you, increasing your mind’s threat detector.
It’s easier to not have something than to have it and lose it. This is the psychology of loss-aversion hard at work. Although it’s your mind’s way of protecting you, it can also keep you stuck.
Your brain’s primary job has been to keep you alive throughout evolution, not necessarily to make you feel happy and thriving. If you feel like you’re going through life in a constant state of coping and never truly thriving, this is your brain’s survival mechanism at work.
When your threat detector is highly sensitized, your overthinking mind keeps you from acting. If this is the case, it might be helpful to consider your relationship to uncertainty.
Analysis paralysis keeps you safe by avoiding the risks that come with making a change. By avoiding the pain of a potential future disappointment, you’re also avoiding the pleasure of thriving. Like an addiction, worrying provides a sort of destructive comfort. Although it’s not necessarily pleasurable, it numbs you to the larger more uncertain pain associated with the vulnerability of change.
“You can’t numb those hard feelings without numbing the other affects, our emotions. You cannot selectively numb. So when we numb those, we numb joy, we numb gratitude, we numb happiness. And then we are miserable, and we are looking for purpose and meaning, and then we feel vulnerable, so then we have a couple of beers and a banana nut muffin. And it becomes this dangerous cycle.”
When you avoid pain, you also avoid pleasure.
Choosing to take a step into the unknown breaks this cycle. I use the word “step” because it’s often tempting to imagine change to require a massive overhaul of one’s life. This all-or-nothing approach is the reason why New Year’s resolutions often fail.
Like the 12-step recovery saying, “one day at a time,” approaching change with this attitude makes changes more sustainable and less intimidating.
When your mind races back into the future-planning mode with the constant “what if’s” you can catch it and bring it back to the present. Then, you can ask yourself, “what do I need to focus on today?” If taking it one day at a time is too overwhelming, perhaps consider taking it one hour at a time or one moment at a time. What is the next practical step?
In completing small practical steps, you gain motivational momentum through small wins. The other aspect of motivation consists of understanding your “why.”
As Friedrich Nietzsche states:
“He who has a why to live can bear almost any how.”
Understanding your “why” requires getting clear on your values.
As described in my article on How to Improve Psychological Flexibility, values can be found by looking at one’s role models. Pick a person you admire. What qualities of theirs do you admire? Some examples might be compassion, creativity, or genuineness.
Clarifying your values goes beyond just “niceness” or “being a good person.” These things turn values into rules, making them highly unmotivating. Instead, clarifying your values allows you to be the author of your life. What do you stand for? What quality do you want to bring forth into the world? What causes do you genuinely care about?
If you’re looking for a psychologically validated exercise to gain further clarity in this area, I recommend checking out the Self Authoring Program.
Values are something we choose for ourselves. They are not meant to be rigid, constraining, or rule-based. Although values may be culturally informed, we still have the freedom to choose what we want to stand for and how we want to show up in the world.
Rather than going through life, “just following orders,” choosing our values can give a sense of meaning, purpose, and self-determination in otherwise stressful situations.
Courage to act does not come from the absence of fear. Instead, it means acting despite the fear by getting focused on what you want and why you want it.
Conclusion
Throughout this article, I’ve discussed ways you can stop overthinking and start living the life you want.
Based on the principles of Acceptance and Commitment Therapy (ACT), I’ve summarized the three major themes that compose psychological flexibility: openness, awareness, and engagement.
In practical terms, this requires accepting uncertainty, noticing the present moment, and acting in alignment with your values.
If you want an even more in-depth overview of this therapeutic approach and its theoretical underpinnings, you can check out my article, How to Improve Psychological Flexibility.
In that article, I delve into each of the pillars of psychological flexibility, providing metaphors, practical exercises, and explanations of why it works.
On the go? Listen to the audio version of this article here:
Many people struggle with repetitive thoughts racing through their head, beginning with the phrase, “what if…”.
What if I can’t handle all of this? What If I fail? What if I’m not enough?
Whatever follows the “what if” statement generally involves the following factors:
An uncertain situation
A perceived catastrophic outcome
Perception of personal inadequacy
For example, if you’re uncertain whether you’ll be able to pay the bills this month due to a shortage of work, your mind may go on overdrive, dwelling on the worst-case scenario. You imagine losing everything.
You then beat yourself up with thoughts of being worthless. Focused on these thoughts, you cannot sleep, making it more challenging to take action due to mental fatigue and feeling overwhelmed.
Overthinking is different from critical thinking. Overthinking is based on fear, whereas critical thinking is based on curiosity. The former is closed whereas the latter is open.
In our time of increasing uncertainty, anxious thoughts about the future are a common form of overthinking. On the mild end, overthinking consists of occasional worrying. On the severe end, it consists of debilitating anxiety.
According to research, roughly a third of people suffer from an anxiety disorder at some point in their life. As a counselor, this is one of the most common issues I see people struggling with, so if you can relate to this issue, you are not alone.
In this article, I use the word overthinking instead of anxiety to separate it from the diagnostic realm. Many people experience forms of worrying that do not necessarily become an anxiety disorder. High functioning anxiety is another non-diagnostic term that has been used for this issue.
Like persons with anxiety disorders, many people who regularly engage in overthinking are high functioning, intelligent, and successful in their fields. They can outwardly appear to have everything together while bottling up increasing levels of stress.
Table of Contents
What Causes Overthinking?
As someone with an academic background, I value thinking. As I entered the counseling field, I noticed how too much thinking is part of the problem for many people. Rather than getting you closer to your goal, overthinking can cause procrastination, anxiety, and other health problems caused by stress.
Since overthinking is counterproductive, what is its purpose? What causes overthinking?
Overthinking is caused by the brain’s need to create a sense of order and certainty when faced with uncertainty. Its inability to gain certainty in uncertain situations results in a fear response, provoking further thinking to resolve this discrepancy.
For example, uncertainty regarding the meaning of one’s physical health symptoms can result in overthinking. You may turn to google, checking the meaning of your symptoms, leading to further uncertainty when told it could range from a minor infection to symptoms of a specific kind of cancer. This can then spiral you into a panic, worrying about worst-case scenarios, imagining you’re not going to survive.
Thinking can spiral into overthinking, which can spiral into panic, magnifying the physical symptoms and creating further symptoms resulting from the increased stress.
As things start to feel overwhelming, it is tempting to double down on problem-solving. But, unfortunately, since thinking likely got you into this situation, more thinking is not the way out.
Since this kind of thinking is generally focused on things outside of your control, it only gives you the illusion of control. Worrying feels productive but only digs you deeper into the anxiety pit.
Is Overthinking an Addiction?
Recently, I discovered how overthinking is a form of addiction.
As an addiction counselor, I understand addiction as the continued use of substances or addictive behaviors despite adverse consequences. The addiction creates an illusion of control while leading to the loss of control over one’s situation.
Consider how overthinking does the same thing. Many people continue to worry about a situation, despite the negative consequences of this worrying. Worrying can make you feel like you are productive when in reality, it takes away from your ability to take action on things within your control.
This way of conceptualizing overthinking goes deeper than just surface-level similarity.
According to Judson Brewer MD PhD in his new book Unwinding Anxiety, worrying is a form of addiction. Like playing a slot machine, it is unproductive in the long-term, but worrying sometimes results in perceived random payoffs, keeping you hooked.
For example, perhaps you are worried about not getting a promotion at work, and then you get the promotion. Although your worrying did not necessarily cause the promotion, they become associated in your mind.
This is how persons with a gambling addiction develop superstitions or theories regarding patterns. When a random reward is presented, our brains try to determine the cause of this reward. This is an ancient survival mechanism that helped us find patterns in nature.
Random rewards trick the brain into perceiving patterns where none exist. Although the superstitious behaviors have no connection to the actual outcome, they give an illusion of control.
There are random moments where things outside of your control happen to work in your favor when worrying. This reinforces the worry pattern since your brain begins to associate the worrying and the outcome falsely.
Over time, you become psychologically dependent on worrying, believing it is the only thing holding everything together. Although worrying can have some short-term benefits if it spurs a necessary action—as discussed in my article here—its long-term effects are generally unhelpful.
“…worrying is as effective as trying to solve an algebra equation by chewing bubble gum.”
Beyond not being helpful, 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.”
Although many people think of addiction in terms of drugs or alcohol, behavioral addiction often goes unnoticed.
Consider how your relationship to your phone might resemble a gambling addiction. You are bombarded with randomly rewarding notifications. Hearing the buzz, you’re compelled to check, uncertain of the potential reward waiting for you. If you’re interested in seeing if you’re addicted to your phone, I created a self-assessment quiz in my article here.
If the compulsion to check your phone is driven by fear rather than a potential reward, the same addictive process is at work. This form of checking is like worrying. It makes you feel busy and productive while taking away your ability to focus on what matters most.
Applying the concept of behavioral addiction to worrying, Judson Brewer classifies worrying as a “mental behavior,” even if it does not lead to physical action such as checking your phone.
For example, many people find themselves living in their head on Sunday afternoons, worrying about all the work they need to do on Monday morning. Unfortunately, spending time and energy on this mental behavior may not involve doing actual work. In fact, it likely takes away from your ability to do the actual work since it can lead to loss of sleep and mental fatigue.
Overthinking is like running on the mental treadmill. It keeps you busy with the endless pursuit of control over the uncontrollable. But, like gambling superstitions, it is a futile attempt to gain a sense of certainty and predictability where it does not exist. More thinking merely puts your mental treadmill on high speed, expending the energy that could be applied to more worthwhile endeavors.
Signs of Addiction to Overthinking
Here are a few signs you may be addicted to overthinking:
You mentally over-prepare to avoid difficult emotions.
Although thoughtful attention to detail and preparation is helpful, overthinking involves repeatedly resorting to the problem-solving mindset to suppress underlying emotions. Like an addiction, the rational mind becomes the drug, providing temporary relief at a long-term cost to the emotional mind. As described in Dr. Gabor Maté’s book, When The Body Says No, this can result in various forms of physical illness.
You continually focus on the way things “should” be.
Constantly focusing on the way things “should” be can be a mentally rigid way of not accepting the way things are in reality. Although it is helpful to maintain critical thinking and push for change when things are unjust, or systems are broken, overly focusing on the “shoulds” often becomes counterproductive. This attempt to gain a sense of order often amplifies the sense of disorder, creating a sense of helplessness. This can diminish one’s ability to take action on aspects of the issue directly within one’s control.
You spend a lot of time living in the future or the past.
Worrying about the future or dwelling on the past can be forms of overthinking that keep you from living in the present. Although it is helpful to plan for the future and learn from the past, overthinking about these areas can be like driving without looking at the road directly ahead of you. Fixating on the GPS (future planning) or the rear-view mirror (past dwelling) makes it challenging to engage in safe and effective driving.
You are driven by the thought of not being enough.
Constantly thinking about yourself in comparison to others makes you feel isolated. This way of operating fuels an inner voice of shame, telling you you’re not good enough. Although it can be helpful to strive for progress in one’s life, it is counterproductive when heavily fueled by social comparison. When coming from a place of not being enough, your mind will only race faster as you progress, often resulting in self-sabotage due to the underlying sense of being unworthy or unable to handle success.
You lose touch with your underlying values.
Overthinking can often come from being overly preoccupied with what is expected of you. Rather than acting for the purpose of self-care or to maintain alignment with your values, you often worry about others and worry about doing enough to satisfy their expectations. Although helping others can be based on genuinely valuing compassion, losing touch with this value can lead to constantly doing things for others, neglecting self-care, and worrying about what other people think. As a result, you become hyper-focused on the goal but lose touch with your “why”.
You constantly find yourself in analysis paralysis.
Although analysis can be helpful, it becomes a form of overthinking when it takes away from your ability to act. Analysis paralysis is a form of perfectionism fueled by a sense of insecurity regarding one’s abilities or one’s underlying sense of being an imposter. This process results in procrastination. On the surface, procrastination often looks like laziness, but this is often far from reality. An unwillingness to take action is usually based on fear, and overthinking is an unhelpful attempt to gain a sense of certainty.
Conclusion
If you find yourself engaging in ineffective attempts to gain a sense of control by overthinking, it can be helpful to take a step back and notice when this is happening. In these moments, noticing how these mental habits are unrewarding allows you to break the illusion of control. Immediately recognizing this, you can shift your focus to something directly within your control, noticing the reward value of this alternative behavior.
If you want to learn more about breaking worry habits, I highly recommend the new book Unwinding Anxiety by Judson Brewer MD PhD. In the book, he lays out a practical step-by-step approach to rewiring your brain’s reward circuitry to address habitual worrying.
On the go? Listen to the audio version of the article here:
As a chemical dependency counselor in a detox facility, I watched many people go through withdrawal from substances. Coming off opioids is the most painful, coming off stimulants leads to a lot of eating and sleeping, but coming off depressants like alcohol is the most dangerous. Although it is difficult, I’ve seen many people successfully go through the process and see the benefits of living a sober life.
Many people underestimate the danger of alcohol withdrawal since the substance is so widely available and socially acceptable.
The reason why alcohol withdrawal is so dangerous is because it can lead to severe seizures. While working with individuals coming off of alcohol, I had to keep a close eye on them, regularly monitoring their symptoms in case emergency medical support was required.
Alcohol withdrawal symptoms range from mild shaking in the hands to severe anxiety, restlessness, and full-body trembling, depending on the severity of the substance use.
If you or someone you know has been drinking daily for an extended period and wants to stop, it is important to seek medical direction from a family doctor or support from a local withdrawal facility.
Table of Contents
What is Alcohol Withdrawal?
Alcohol withdrawal happens when a person dependent upon alcohol suddenly stops drinking or drastically reduces their intake.
Alcohol withdrawal is the result of a neurological rebounding effect. The process is initiated by two categories of neurotransmitters: excitatory (stimulating) and inhibitory (relaxing).
Excitatory neurotransmitters increase the likelihood that a neuron will fire an action potential. Inhibitory neurons are the exact opposite, and their effect decreases potential neural firing. Alcohol consumption increases inhibitory neurons and decreases excitatory neurons.
The brain’s main inhibitory chemical is GABA (gamma-aminobutyric acid), and the main excitatory chemical is Glutamate. When a person drinks alcohol, the brain signals GABA to increase, and Glutamate decreases, resulting in the sedating effect. Over prolonged use, your brain adapts to the sedation by boosting Glutamate, resulting in tolerance to alcohol. Therefore, you need more alcohol to get the same sedating effect since your brain’s Glutamate system is on overdrive to counterbalance the increased GABA.
If you suddenly stop consuming alcohol after your brain habituates to being sedated by its effects, your brain is pushed off balance into a hyper-stimulated state. As described before, this can mean shaking, anxiety, restlessness, or seizures.
Alcohol Withdrawal Severity
According to a person’s level of physical alcohol dependence, symptoms will vary. This dependence severity includes the amount of alcohol, the frequency of consumption, and the length of time this level of consumption has been occurring.
This is the beginning of alcohol withdrawal symptoms such as hand tremors, gastrointestinal issues, mild anxiety, headaches, and insomnia. This may be the extent of the symptoms for many people experiencing withdrawal.
Stage two (moderate):
Along with the symptoms of stage one in mild frequency, stage two symptoms will include increased abnormal rapid breathing, increased blood pressure, and mild hyperthermia. This stage is from 1-3 days after discontinuing alcohol.
Stage three (severe):
Stage 3 includes symptoms of stage two and may also cause hallucinations, seizures, attentional issues, and disorientation. This stage can start at a week and can last up to several weeks.
While the specific alcohol withdrawal symptoms will vary from person to person, these stages are a rough guideline to categorize severity. If you are experiencing symptoms, it is important to seek immediate medical support.
Although most people recover from their symptoms without medical detox, support from a medical professional can minimize risk.
A Timeline of What to Expect
Alcohol detox symptoms can occur for up to 5-10 days after your last drink. Most detox facilities offer 24-hour supervision for five days, covering the period when you are most at risk. Although it is different for everyone, here is a general timeline of what to expect:
6-12 hours after last drink
The mild symptoms of stage 1 may start to appear, including mild anxiety, headaches, insomnia, and upset stomach.
24 hours after last drink
Some people start to experience hallucinations at this point, including visual, tactile, and auditory hallucinations. However, this is not common for persons going through mild withdrawal.
24-72 hours after last drink
At the 24-48 hour mark, seizure risk increases. Again, seek medical supervision if the shaking in the hands becomes severe or you have a history of seizures. From 48-72 hours, withdrawal delirium may also appear.
After the acute symptoms subside, some people may experience fatigue, mood changes, and sleep disturbances for months as the brain continues to adjust.
Treatment for Alcohol Withdrawal
Detox is the first step in treatment if you are experiencing alcohol withdrawal. It is essential to talk to your doctor or seek support from a local withdrawal facility during this stage of the process.
A standard prescription protocol given by medical doctors for alcohol withdrawal consists of a benzodiazepine taper. In plain language, this generally consists of being prescribed an anti-anxiety medication like Valium over five days, slowly lowering the dosage each day.
The benzodiazepine taper can be ordered for a person to do at home with constant supervision or in a withdrawal facility under the supervision of nursing staff or chemical dependency counselors.
Other commonly prescribed medications include clonidine to manage acute high blood pressure and extra strength ibuprofen to manage the discomfort.
Although treating the physical symptoms is the first step, there is a high likelihood of relapse if it is not immediately followed by counseling or residential programming. This is because the detox only addresses the physical aspects of withdrawal and not the cognitive or behavioral characteristics of the addiction.
Inpatient or residential treatments
Inpatient treatments involve around-the-clock support and programming. Some residential treatment facilities offer medical detox, and most offer group therapy, individual therapies, and other recreational activities. Some may also provide aftercare groups or more intensive aftercare programming such as a sober house.
Outpatient treatments
Outpatient treatments consist of individual counseling, such as the service I offer. This includes having weekly or bi-weekly conversations about the cognitive and behavioral elements driving the addiction and developing a plan to navigate challenging situations, reducing the risk of relapse effectively.
Outpatient group therapies can also be another option for treatment. This generally consists of attending a regularly scheduled group program. One of the benefits of outpatient treatment is that you can practice skills in your real-world context between sessions, integrating them into your daily life.
Another resource that can be drawn on after detox includes peer-support groups such as 12 step AA meetings. The benefit of 12 step programming is that it is free and widely available.
The 12 step process also allows individuals to gain a mentor in the form of a “sponsor”. This person helps guide you through the steps, often offering immediate peer-support when thoughts of relapsing occur. This kind of programming gives a sense of belonging, connection, structure, and the sense of not being alone in one’s struggles.
Conclusion
Recovery can be challenging at times, but with the proper support, you can safely make it through the process. The initial stage of withdrawal can be physically demanding, and the long-term process can be psychologically challenging.
If you notice signs of alcohol withdrawal, it is crucial to seek immediate medical support. Talk to your doctor if you plan to discontinue alcohol after a sustained period of regular use. This is especially important if you have a history of seizures.
Getting over the initial physical symptoms allows you to seek ongoing forms of psychological support where you can delve into what drives your addiction and how to move forward more effectively, gaining long-term freedom from addiction.
If you have a love-hate relationship with food, you may find yourself constantly thinking about it, depriving yourself of it, or compensating for foods you’ve eaten.
Like the cycle of an abusive relationship, food seduces you with its charming lure of comfort, often resulting in shame, regret, or physical pain.
You tell yourself you’ve had enough, and this is the last time, but you keep going back to old patterns. This can manifest as food addiction or eating disorders such as anorexia, bulimia, or orthorexia—an addiction to dieting.
If you have an unhealthy relationship with food, there is a way to heal.
In this article, I will illustrate how diet-culture perpetuates counterproductive messages about eating. When these cultural messages result in shame, they fuel the problem they were intended to solve.
Diet-culture moralizes food, resulting in a constant sense of resisting temptations. As psychologist Carl Jung states, “What you resist persists.” In constantly resisting food, it gains more power over your life.
This article will highlight the sociological and psychological forces keeping millions of people stuck in this unhealthy dynamic.
By healing your relationship to food, you can break free from these messages and reclaim your mental and physical health.
Table of Contents
What is an unhealthy relationship with food?
If you struggle with an unhealthy relationship with food, you are not alone.
This is an invisible issue affecting the mental health of millions of people, perpetuated by well-intentioned health professionals and diet gurus.
It comes in many different forms and severity, ranging from relatively benign to severe and life-threatening.
Here are some signs you might have an unhealthy relationship with food:
You classify certain foods as good or bad.
Although certain foods are better for nutrition than others, a strong moralizing stance focuses on weight or willpower, making the body something to be overcome rather than nourished.
By labeling foods as “bad,” we feel the need to constantly resist them, fueling even further desire. The sense of deprivation and forbidden nature of “bad” foods amplifies their allure. When succumbing to the temptation, eating “bad” foods leads to shame, fueling even further binging or strict food avoidance, adding to the vicious cycle of unbalanced eating.
You are overly preoccupied with food.
Although it is effective to plan for healthy meals to maintain your energy and nutrition, becoming overly preoccupied with food gives it power over your life. Rather than food serving you, you begin serving it.
Like an addiction, preoccupation with food takes away from your ability to focus on other important areas of your life, resulting in a constant state of vigilance and energy depletion.
You restrict food and or binge on food.
This is the core problem with diet-culture. Since dieting emphasizes restricting certain foods, it gives these foods power. As described above, “What you resist persists.” Although the nutritional science backing a specific diet may make sense, diets don’t work psychologically.
Food restriction often results in food binging, perpetuating the yo-yo dieting cycle.
You eat based on rules rather than internal cues.
Diets are also counterproductive because they disconnect you from your body. Rather than eating based on internal hunger and satiation cues, diets reinforce mistrust of the body’s cues.
Eating based on these external rules keeps dieters in their heads rather than in tune with their bodies, resulting in a sense of deprivation, fueling the desire to rebel against these rules.
You feel guilty when enjoying food.
When enjoyment is synonymous with guilt, it takes away a genuine sense of satisfaction. When genuine satisfaction is lacking, binging on one’s “guilty pleasure” replaces natural satiation.
Like the cycle of deprivation and binging, guilty pleasures become scarce resources. This scarcity fuels binging rather than genuine enjoyment.
You become obsessed with numbers and nutritional labels.
Although it can be helpful to be guided by a food’s nutritional value, an over-fixation on numbers and labels can keep you trapped in a form of preoccupation with food, resembling addiction at an extreme end.
This unhealthy obsession with healthy eating has been called orthorexia. It can result in compulsive label checking and nutrition tracking, resulting in long-term damage to one’s mental and physical health. Like an addiction, the perceived solution is actually the problem in disguise.
You eat for the primary purpose of changing your body.
Although your body can change based on your eating habits, punishing your body to achieve your weight goals sets you up for long-term mental and physical instability.
If changing your body comes from a place of self-loathing, progress becomes about the numbers rather than your mental wellness. This definition of progress can only be sustained for a limited period of time since the underlying strained relationship with your body is increasingly reinforced.
You restrict food to gain a sense of control.
Eating disorders are often an attempt to gain a sense of control in one’s life. If you have been in a chaotic environment or an overly strict environment, your sense of control may have been taken away. Restricting food or binging on food are ways to gain a sense of control.
Like an addiction, this is an illusion of control. When discovering the reality of one’s relationship to food, one may realize how they paradoxically give away further control, allowing food to dictate their lives.
You use food to cope with difficult emotions.
Although many people use certain foods to relax, like alcohol is used to unwind, it becomes a problem when it becomes a person’s go-to solution to underlying problems, resulting in increasing use despite negative consequences in one’s life.
Difficult emotions such as fear or guilt from the past can trigger emotional eating or food restriction to escape the pain or gain a sense of control. As stated above, these are short-term solutions resulting in more significant problems in the long-term.
You hide certain eating behaviors from others.
Moralizing food can lead to shame and secretive eating to avoid further shame. Like an addiction, someone can present as highly functional while hiding their use of a specific substance or behavior.
Rather than reducing the shame, these secretive eating sessions further contribute to a sense of shame, making a person feel even further disconnected from others.
What causes an unhealthy relationship with food?
Diet-culture causes an unhealthy relationship with food. This unhealthy relationship is further reinforced by psychological triggers such as habitual emotional coping through food restriction or binging.
As a former personal trainer, I learned about the toxic side of fitness and diet-culture from within the industry. During my time as a trainer back in 2010, it was also the height of the weight-loss television genre.
It seemed like everyone and their workplace was developing some kind of Biggest Loser challenge. I had even unknowingly participated in this fat-centric fitness focus, creating my own Bootcamp fitness program called “The Last Ten Pounds,” which I ran out of a local facility.
I preached the standard gospel of avoiding sinful foods and exercising to lose weight. Although it made biological sense, I didn’t realize how it was counterproductive psychologically.
Sensing something was wrong with this body-transformation-obsessed fitness culture, I conducted research on the popular weight loss genre in my Master’s thesis in sociology. Completed in 2011, you can find the full thesis here.
In short, I demonstrated how transformation narratives in the weight-loss genre are a warped version of Christian morality, demonizing fat and idealizing reason and rationality as the way to overcome the body and its desires.
In my research, I did a discourse analysis of MTV’s “I Used to Be Fat,” a show where recent high-school graduates are subjected to intense body transformations in the summer before college. Gaining control over their bodies by getting one’s weight down to a specific number on the scale was the sign of overcoming adolescent immaturity and gaining entry into adulthood.
Each episode begins with a confession by the participant standing in front of a mirror, talking disparagingly about their body, reinforcing their underlying self-loathing.
Next, the participant is subject to a penance whereby they “cleansed” their body of “toxins” through an overly intense first workout.
During each episode, temptations such as cookies are presented, generally from a maternal figure. Inversely, a mentor emerges, generally from a paternal figure, who helps them along their hero’s journey.
Lastly, salvation is achieved when the body is overcome through intense discipline, and the final number on the scale is revealed.
Normalizing extreme body transformations sets people up for long-term yo-yo dieting and mental health issues. Rather than focusing on their long-term relationship to food and their bodies, the show normalizes a toxic diet-culture focused on food restriction for weight loss.
The underlying message is that arriving to college without a slender body would result in further shame and lack of belonging.
By focusing on fitness as the cure for low self-esteem, the psychological issues are left unaddressed, leaving a person more vulnerable to disordered eating.
Diet-culture preaches problematic messages about willpower and discipline. Although these may be noble traits at times, they are ineffective when portrayed as the only psychological tools.
As an addiction counselor, I now understand the true shortcoming of willpower. It can get someone over a craving momentarily, but it quickly depletes, leaving a person more vulnerable to temptation if there are no other psychological coping strategies in place.
Although discipline can be an admirable trait as well, it is necessary to question the source of this discipline. The Latin root of the word ‘discipline’ comes from ‘disciple,’ or follower of Jesus. In the modern weight-loss context, we are disciples of diet-culture, disciplining our bodies to overcome their desires.
Accepting the gospel of diet-culture puts you at constant war with your body. It implies the body cannot be trusted and needs strict rules to keep it in check.
By getting out of your body and into your head, your body is put into a constant state of deprivation, resulting in intermittent rebelling, fueling the cycle of shame and disordered eating.
This critique of diet-culture goes beyond a social justice lens. Diet-culture is stigmatizing and psychologically ineffective at achieving its own goals.
How to have a healthy relationship with food
If you are tired of being constantly at war with your body, there is a better way forward.
If you want evidence-based practical advice on how to heal your relationship with food, I highly recommend checking out Intuitive Eating by Elyse Resch and Evelyn Tribole.
This book is written by two registered dietitians whose approach to healthy eating is based on psychological evidence about what works in the long-term.
Their revolutionary anti-diet approach to healthy eating is based on getting in touch with your body’s needs—the exact opposite of diet-culture’s focus on disconnection from one’s body through rules, restriction, and willpower.
Intuitive eating does not mean throwing caution to the wind and engaging in massive fast-food binges. This potential criticism of removing food restriction is steeped in the logic of diet-culture. Instead, intuitive eating sidesteps this the deprivation-binging cycle by not restricting any foods. Taking the morality out of food takes away its power over your life.
Instead of following a strict set of diet rules, intuitive eating rebuilds trust in your body as you listen to its needs and eat according to its hunger cues and responses to food.
Although this approach sounds counter-intuitive, it resonates with my understanding of the psychology of addiction.
Persons struggling with dieting resemble someone struggling with an addiction. Dieting is a short-term solution to a long-term problem. It provides temporary relief, with long-term harms. It gives you the illusion of control, but actually takes away your control in the long-term. It preoccupies your mind, taking away your ability to focus on things that matter. Lastly, it is a process fraught with constant instability and relapse.
Like how someone struggling with an addiction needs to give up the substance to regain control, the intuitive eating approach advocates complete abstinence from dieting.
By giving up dieting, you can end the war and make peace with food. By making peace with food, it takes away its forbidden allure. If everything is allowed, nothing takes on the psychological specialness of being a forbidden fruit. Just as marketers and economists know very well, when something is scarce or rare, its value increases.
By making peace with food, you can focus on satisfaction when eating, increasing your ability to stop eating when your hunger is satiated because you are not operating in a state of deprivation.
Rather than using the term “junk food,” the intuitive eating approach labels these as “play foods.” By changing the moralizing language around food, you take away its power over your life. Consider that we regularly use terms like “sinful, tempting, or cheating” when referring to food. This language only increases the forbidden fruit effect, giving food more power over your life.
Intuitive eating requires getting in touch with your body and its needs. It means honoring your hunger and feeling your fullness. When living in your head, you become out of touch with the body’s needs and are perhaps out of touch with hunger and fullness signals.
By respecting the body rather than treating it as an object to be overcome, you develop self-compassion. By treating your body like something you care about, rather than something to be beaten up and deprived, you heal your relationship with yourself, and therefore your relationship to food.
Healing your relationship to physical activity
Shows like The Biggest Loser often made the gym look like a chamber of punishment, with contestants puking, fainting, or falling off treadmills.
When you heal your relationship to food, you may consider your relationship to physical activity. Rather than seeing physical activity as a punishment, it becomes an opportunity to enjoy the feeling of physical movement.
Since COVID, we have all learned that the gym is not the only outlet for physical activity. Although some people like myself enjoy the gym, the key to long-term health is enjoying the process; otherwise, like dieting, the activity will be temporary.
Also, as a former personal trainer, one would imagine my gym routine would be rigid and numbers-focused, but this is quite far from reality. For the past few years before COVID, I would show up to the gym without a plan.
Walking through the gym, I started moving my body, feeling any soreness from previous workouts. If a particular muscle group was not sore from the previous workout, I’d consider which kind of exercise felt interesting for that muscle group and which type of movement or equipment I felt attracted to at that moment. Each next activity was decided at the moment, without regard for any rules or plans. The gym felt like my playground.
I actually stopped using weights and machines for about a year or so, just enjoying the pullup bars, TRX ropes, gymnastic rings, and other body-weight exercises such as pushups and pistol squats. This gymnastic-style workout kept me highly motivated due to the enjoyment of making progress with new forms of movement and the need to remain highly in tune with my body’s needs and limits.
In my days as a personal trainer, if someone asked me for exercise advice, I’d give them a basic circuit training routine or a more advanced split training routine with an 8-12 rep range. Although these plans may be physiologically adequate, they are often far from psychologically adequate. If going to the gym is a terrible experience, you’ll probably not go for too long. The most optimized exercise plan is worthless if it’s not being used.
These days, when someone asks for a workout plan, I ask them what they enjoy. I inquire about all of the outdoor activities they enjoy, sports they’ve participated in, and what things they’ve perhaps enjoyed doing at the gym. I also inquire about activities they may be curious about but have not tried. I then ask which of these enjoyable forms of movement are realistic, given their current lifestyle and schedule.
Like giving up a diet mentality, healing your relationship to exercise means not depriving yourself of genuinely enjoyable movement, focusing on function rather than numbers gets you in touch with your body, rather than trying to subjugate it to a form of rationalized discipline.
Recognize the six internal food voices
In Intuitive Eating, the authors highlight six food voices that are helpful to recognize when healing your relationship with food.
The Food Police
This is the familiar moralizing voice of diet-culture. Certain foods are forbidden, and the food police condemn the temptation to indulge in these sinful foods.
The food police may have initially been a parent, coach, or partner. Now, the internalized voice of the food police fills your head with “should’s” and “should not’s,” making you feel guilty when breaking a diet law.
The food police are punitive and may even lead to the compulsion to use exercise as punishment for “bad behavior.”
The food police is an unhelpful voice that separates you from your body. When it pops up, it can be acknowledged and gently reminded that its rules no longer apply because you no longer operate in its jurisdiction.
The Nutrition Informant
The nutrition informant feeds the food police up-to-date information on the latest diet fads. In the past, it cautioned against high-fat diets and counting calories. Now, it’s generally focused on counting macros and minimizing carbs.
The nutrition informant can be your ally if its information is used to help you understand the various nutrients and ways of eating so you can more carefully experiment with how your body responds to certain foods.
The Diet Rebel
The diet rebel is the voice that starts getting louder right before a binge. It tells you you’ve had enough deprivation, and you deserve to indulge. It can also appear as the apathetic voice of “screw it, you only live once.”
When you listen to the food police for too long, the diet rebel starts gaining strength. After a period of deprivation, it is only a matter of time before it shows up.
The diet rebel can be your ally when you direct it at diet-culture, body shaming, or other attempts to cross your food boundaries.
The Anthropologist
The anthropologist is the helpful voice of an observer perspective. Rather than merely reacting to the unhelpful food voices, you can step back and observe what is happening.
Like an anthropological researcher, you can observe the social dynamics of your inner food voices. In addition, you learn to observe your bodily cues, studying their subtle sensations of hunger and fullness.
The Nurturer
The nurturer is the helpful voice of self-compassion. It talks to you the way you would speak to someone you care about. If the shame of diet-culture remains strong, this voice may not come naturally and must be ingrained over time.
The nurturer helps you recognize when difficult emotions are triggering the desire to cope by using food. It reminds you of helpful coping skills and encourages you to reach out to others for support during challenging moments.
The nurturer also reminds you to approach intuitive eating gently. It says, “progress, not perfection.” When you are tempted to beat yourself up for any perceived imperfection, it talks to you kindly instead.
The Intuitive Eater
The intuitive eater is the combination of the anthropologist and the nurturer. It draws on the allied version of the nutrition informant and the allied version of the diet rebel.
First and foremost, the intuitive eater trusts your gut.
Conclusion
Healing your relationship with food means healing your relationship with yourself and your body. It means taking the morality out of food, letting go of any attempt to impose rigid rules on your eating habits.
Intuitive eating does not mean throwing caution to the wind and living on a steady fast-food diet. This would be against the tenants of intuitive eating since listening to your body would likely tell you it does not actually feel satisfying choosing these foods in excess.
By taking back your body’s intuitions, you start listening to its cues and regaining its trust. If your relationship with food has been heavily affected by diet-culture, it may take time to regain your own trust. Like any strained relationship, patience is required.
Although intuitive eating sounds simple, many people find it just as difficult as dieting in the beginning. Not having strict rules and regulations around food means you have to constantly check in with your body to maintain balance.
Over time, this approach becomes natural. Healing your relationship to food allows you to take back control over your life and start focusing on what matters, regaining your health in the process.
If you want to learn more, I highly recommend checking out Intuitive Eating by Elyse Resch and Evelyn Tribole. Their approach is supported by a great deal of research and has been revolutionary for many people.
As an addiction counselor and former personal trainer, I believe the intuitive approach to eating is based on a deep understanding of the psychology of motivation.
If you struggle with yo-yo dieting or an eating disorder, I highly recommend checking out the book.
On the go? Listen to the audio version of the article here:
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.
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.
Table of Contents
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.”
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.
For more on the root causes of addiction, check out my interview with Stephanie from Aegis Health Group:
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.
Table of Contents
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.
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?
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.
