When and where exactly addictions begin can be very hard to pin down. Many of us can be said to follow habits or routines which are of central importance to us, dependencies which to some extent might even structure our lives and without which we feel perturbed or perplexed.

Addictive behaviours can evolve out of different conditions; we can turn to certain habits as a distraction from stress, anxiety, anger, pain or sadness, as a replacement for an emotional absence created by loss or by unmet needs, or in order to relieve boredom and frustration.

Differing definitions

Addiction is sometimes conceived of as a primarily physical or biological problem. Addicts, in this version, are biologically pre-disposed to addiction and are often defined as those whose bodies have become reliant on a substance in order for it to regulate itself.

However, although physical addiction is very real when someone is experiencing the bodily effects of substance withdrawal, the psychological reasons for addiction are much longer lasting than any physical attachment. After the physical withdrawals of severe substance addiction are through people still remain recovering addicts.

It can be common, for example, to substitute one addictive behaviour for another, or to become hooked on habits such as gambling, shopping or cleaning, which are not based on any drug or brain effect. The habit itself only matters up to a certain point; beyond that it is reality, and the need to take action under certain circumstances, which demands our attention. Treating addiction requires an understanding of how it works psychologically.

A way to wrest back control

Recovering addicts will report that the time they most feel like returning to their addictive behaviours is not when they are particularly relaxed or feeling self-indulgent, but rather when they feel ill-at-ease, helpless either to certain life circumstances or to their own unwelcome feelings.

Their behaviour is a way to wrest back control, a way of creating a sense that they and the world are as they should be, and a means of managing painful emotional states and regulating their self-esteem. It can also, therefore, preclude an understanding of the deeper causes of distress and prevent the development of healthier forms of self-regulation.

Addiction, seen in this sense, is a disorder of self-regulation, a coping mechanism which has become a symptom, and it is a very common way in which people deal with feelings of powerlessness. Unsurprisingly, addiction is more likely to be found in individuals who were exposed to adverse childhood experiences such as physical abuse and who subsequently have a diminished capacity to regulate negative emotions.

To assert that addiction is essentially about seeking pleasurable experience is to be misguidedly looking through the wrong end of the telescope. And to declare that addiction has anything to do with a kind of moral laxity is plainly wrong.

Addiction therapy

Therapy offers the opportunity for individuals to engage in self-reflection and identify previously inaccessible inner feelings which offer insight into current behaviour and habits. If we acknowledge that addiction has a strong psychological component and people are willing to use the psychodynamic approach to addiction treatment then it is possible to engage with underlying psychological motivations and to develop alternative forms of self-regulation.

The portland practice offers addiction therapy in the form of individual or group psychodynamic psychotherapy from our rooms in Harley Street in Central London. We offer a service which is tailored to the personal and private needs of every individual, and our team have a great degree of experience in supporting addiction treatment.