One of my first eye openers in clinical practice was an experience that occurred many years ago. A young woman was admitted in the psychiatric hospital. She had complaints of alcohol dependence. I happened to be her doctor. On talking with her, it became apparent that the young lady was very intelligent. She had done well in life. She was a professional. She had married well. But she was having major difficulties in her marriage because of her drinking. Three times before her then admission, she had been treated in various psychiatric hospitals for alcohol problems. Each time, she went back on drink. She was treated each time with medication with little input by counseling services. Her problems had started when she was raped about twelve years previous. She had not talked about it to anyone. Maybe she did not tell her previous doctors about it. I had the opportunity to work with her trauma of rape. She stopped the abuse of alcohol and her life changed. Addiction can occur in many forms. A person can be addicted to alcohol, street drugs, gambling and even sex. In all these activities the person engages themselves either for a buzz or a crutch. Many people start with alcohol usage to help them sleep. This then becomes a habit and the person cannot control it. It then starts affecting many spheres of their life. The financial, social, family and health neglect occurs. Only then is it considered an addiction or dependence. Sex addiction as a diagnosis does not exist in psychiatry at present. But when a persons only focus, dream, activity is some form of engagement with sex, it takes the form of an addiction. It may involve chatting on sex lines, visiting pornographic sites on the internet, having the need to engage in sexual intercourse many times a day, visiting and soliciting prostitutes and even engaging in masturbation many times a day. If we go by the definition of addiction, then one addiction that does not classify itself as addiction is work addiction. When people engage in any work or a job, it increases their productivity. It is then not destructive. Therefore it does not fit into the addiction category till damage is done to various aspects of a persons life. Internet addiction is a new form of addiction developing in the developed world. People engage in such activities because the activities give them pleasure or as in sex addiction, release tension. Scientists have a theory that a chemical neurotransmitter called dopamine is secreted in the brain when we engage in pleasure activities. Many drugs like ecstasy and LSD are non-habit forming drugs. But people still engage in them to get a buzz. This is a word that many drug users use to describe the effect these drugs have. The other commonly used words are uppers and downers. When the nervous stimulation becomes excessive, a person may decide to take a downer like an opiate (heroin) to slow them down mentally. People need these activities or substances to help them become calm. In physiological terms, the body is trying to seek an internal homeostasis (balance) in the hormonal and neurotransmitter systems in the body. These systems become disturbed when the person has gone through emotional distress or abuse that they are not able to come to terms with. Almost all drug dependent people have gone through traumatic experiences in their lives. If they have not experienced traumas, then they have come from pampered backgrounds. In these cases, they become sensitive to even slight changes in their life situations. This happens because they have not been brought up to live independently. Such people tend to play victim roles and expect someone else to get them out of their problems. So from their subjective perspective, they are traumatized. Abuse can be in the form of physical abuse-involving beatings and food deprivation. It can be in the form of sexual abuse- in which a powerful figure, uses the individual for their own sexual and power gratification. Abuse can also be emotional in nature. In this case, it can be in the form of neglect, threat or rejection. Almost all the addicts have such abused backgrounds. The treatment of addictions involves medical or chemical treatment and also dealing with the emotional distress of the traumatic experiences. Treatment without any psychotherapy input by only providing medical treatment may not be sufficient. If the cause is not dealt with, the drives leading to addiction do not change in the body. In the absence of psychotherapy, meditation is the best form of treatment available that a sufferer can use in any form of addiction. |
