Addiction refers to engagement in continued and repeated activities despite negative outcomes, as well as a sense of lack of control over the urge to continue this pattern. Addictions are often misunderstood, and have a long history of stigmatisation. However, recent advances in research on addiction has shed light on the nature and complexity of both substance and behavioural addictions. Individuals may find themselves struggling with addiction to a substance (for example, drugs, smoking, or alcohol), which leads to dependence and tolerance of that substance. They may also find that addiction to processes or behaviours (such as gambling, sex, or shopping) get in the way of functioning. Addiction can cause difficulties in almost all areas of life, especially in our relationship to ourselves and those around us.
There are two main models that explain addiction. The first is the disease or medical model, which suggests that addiction is a complex and chronic illness, much like diabetes or cardiovascular conditions. This model suggests that some individuals are genetically more vulnerable to addiction, and display desensitisation of the reward circuits in the brain. Research suggests that the neurotransmitter dopamine is highly important in this process, because of its role as a reward communicator and thus strong motivator. When an individual engages in a behaviour that releases dopamine, the reward pathway lights up. However, the brain tries to maintain equilibriam at all times, and as such, tries to reduce the amount of dopamine in the brain. Over time, this leads to a need for more of the substance or behaviour to get the same level of reward or pleasure, and ultimately, to a conditioned response to the substance or behaviour. Furthermore, research suggests that individuals with an addiction show reduced functioning in brain regions responsible for regulation and decision-making, another result caused by disruption in the dopamine/reward system of the brain. These changes can leave individuals feeling powerless to their addiction, and require support to shift.
The second main model to explain addiction is the psychological model. This model suggests that addiction is a set of learned coping behaviours in response to our environment, beliefs, thoughts, emotions, and sensations. Frequently, addictive behaviours may begin as a way to cope with other mental health concerns (such as trauma-related concerns, depression, or anxiety), or with difficulties in our environment (such as stress, relationship concerns, or grief). Over time, addictive behaviours become conditioned and overlearned, and individuals struggle to find alternative ways to cope. Additionally, the addicted individual’s behaviour is likely to lead to further difficulties, which in turn may cause an increase in mental health symptoms and maladaptive coping behaviours. This can get individuals stuck in a cycle of addictive behaviours.
Our psychologists will first conduct an assessment of your current concerns, needs, and goals, and collaborate with you on what interventions best suit your needs. From there, we will work together to provide evidence-based treatment, such as:
Volkow, Koob, & McLellan (2016)
Miller, Forchimes & Zweben (2011)