Is addiction a choice or a disease?
When we talk about addiction, the conversation often gets stuck on questions of willpower and morality. We might wonder why someone can't just stop using a substance or engaging in a certain behaviour. This view often leads to the idea of an "addictive personality," a supposed character flaw that makes someone more susceptible to addiction. But what if we've been looking at it all wrong?
Understanding addiction requires us to look deeper than the surface behaviours. It's a journey into the complex interplay of our experiences, our emotions, and our innate human need to feel safe and okay. The truth is, addiction often has less to do with the specific substance or activity and more to do with a person's attempt to find relief from profound emotional pain.
Unpacking the myth of the "Addictive personality"
For decades, the idea of an "addictive personality" has been a popular way to explain why some people develop addictions while others don't. This concept suggests that certain personality traits, such as impulsivity, sensation-seeking, or a tendency towards dishonesty, make a person prone to addiction. However, this theory is not only simplistic but can also be quite harmful. It places blame on the individual's character, creating shame and stigma that can prevent people from seeking help. It suggests that addiction is a fixed part of who someone is, rather than a condition that can be understood and treated. Contemporary research and clinical experience offer a more nuanced understanding. Instead of a specific personality type, it's more helpful to think about a collection of vulnerabilities that might increase a person's risk. These can include:
Difficulty with emotional regulation: Struggling to manage intense feelings like anxiety, sadness, or anger.
Impulsivity: Acting on sudden urges without considering the long-term consequences.
High levels of stress: Living in a constant state of fight-or-flight can make a person seek out ways to escape or numb their feelings.
While these traits might be present in some individuals who struggle with addiction, they are not a guaranteed predictor. Many people with these characteristics never develop an addiction, and many who do don't fit this mould. The concept of an "addictive personality" ultimately distracts from the real, often painful, reasons why someone might turn to a substance or behaviour for relief.
The search for relief: Addiction and trauma
A more compassionate and accurate way to understand addiction is to see it as a coping mechanism. At its core, addiction is often an attempt to manage overwhelming emotional pain or to fill a void left by trauma. When a person experiences trauma, whether it's a single event or ongoing adversity like neglect, abuse, or instability, their sense of safety in the world is shattered.
This can lead to a range of difficult emotions and psychological states:
Chronic anxiety or hypervigilance: The nervous system remains on high alert, constantly scanning for danger.
Feelings of worthlessness or shame: Trauma can deeply impact a person's self-esteem.
Emotional numbness or dissociation: A feeling of being disconnected from one's body, thoughts, or feelings as a way to survive the pain.
A deep sense of loneliness or disconnection: Trauma can make it difficult to trust others and form healthy relationships.
In this state of internal turmoil, the desire to simply "feel okay" becomes a powerful driving force. This is where substances or certain behaviours come in. They offer a temporary escape, a moment of psychoactive relief from the relentless internal storm. Whether it's the calming effect of alcohol, the euphoria of a stimulant, or the distraction of gambling, the substance or activity provides a brief respite from the pain. It's not the substance itself that is the primary draw, but the desirable feeling of relief it provides.
The brain quickly learns to associate this substance or behaviour with survival. It becomes the go-to solution for managing distress. Over time, this creates a powerful cycle where the temporary fix becomes a long-term problem, leading to physical and psychological dependence. The addiction is not the root issue; it is a symptom of a deeper, unaddressed wound.
How your brain adapts to addiction
When a person repeatedly uses a substance to seek relief, their brain begins to change. Our brains are designed to seek pleasure and reward, releasing a chemical called dopamine when we do something that feels good. This reinforces the behaviour, making us want to do it again. Addictive substances hijack this system, causing a massive flood of dopamine that is far more intense than what we experience from natural rewards like food or social connection. This overwhelming surge teaches the brain that the substance is incredibly important, more important than almost anything else. With continued use, the brain tries to adapt to this new normal. It may reduce the number of dopamine receptors or become less sensitive to dopamine's effects. This is known as tolerance. The person now needs more of the substance just to feel normal, let alone to experience the initial high. At the same time, the brain's prefrontal cortex, which is responsible for judgment, decision-making, and impulse control, becomes impaired. The drive to seek the substance becomes compulsive and automatic, overriding rational thought. This is why a person might continue to use a substance despite devastating consequences to their health, relationships, and life. Their brain have been rewired to prioritise the addiction above all else.
Finding a path to healing
Understanding that addiction is often rooted in trauma and a desire to feel okay allows us to approach healing with more compassion and effectiveness. It shifts the focus from "Why don't you just stop?" to "What pain are you trying to soothe?" Healing is not about willpower alone. It's a holistic process of addressing the underlying pain and developing new, healthier ways to cope.
Some key elements of this journey include:
Creating a safe space: Therapy provides a non-judgmental environment where you can explore your experiences and feelings without fear. A therapist can help you understand the patterns that have led to the addiction.
Processing trauma: Working through past trauma is essential to healing the root cause of the pain. This might involve therapies specifically designed to treat trauma, like EMDR (Eye Movement Desensitisation and Reprocessing) or somatic experiencing.
Developing emotional regulation skills: Learning to identify, tolerate, and manage difficult emotions without turning to a substance is a crucial part of recovery. Mindfulness, breathing exercises, and other therapeutic techniques can be incredibly helpful.
Building connection and support: Addiction thrives in isolation. Rebuilding trust and connecting with supportive friends, family, or support groups creates a sense of belonging that can counteract the loneliness that often fuels addiction.
This journey requires courage and patience. It's about unlearning old patterns and gently learning to meet your own needs in a way that is nurturing and life-affirming.
Moving beyond the label
Addiction is a complex human experience, not a simple character flaw. By letting go of the myth of the "addictive personality" and embracing a more compassionate understanding, we open the door to true healing. We can see that the person struggling is not broken or morally weak, but someone who is trying, in the only way they know how, to survive their pain.
If you recognise parts of your own story in this, know that you are not alone and that change is possible. The journey begins with understanding your own unique experience and challenging the old patterns that no longer serve you. By connecting with the parts of yourself that need healing, you can find new ways to feel fulfilled and empowered in your life.
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