Working with addictions and compulsions

Carol A. Butler

It is challenging to modify compulsive or addictive behavior on your own or even with the help of a therapist or a program, and it may be useful to think about the differences between compulsive and addictive behavior in order to work towards change.  

People who engage in compulsive behavior usually recognize it as absurd and irrational, and they feel bad about it before, during, and after engaging in the behavior. Examples of compulsive behavior are feeling you must repeatedly check to see if you locked the door or turned off the stove or wash your hands, or identifying as a “neat freak”.  They are aware they are out of control in this aspect of their life.

Active addictive behavior, in contrast, usually occurs in an altered, less-than-rational state (sometimes described as a trance state or a delusional state), where a person feels they aren’t out of control, they can handle it, won’t overdo it, are just trying to get relief or escape discomfort. Once the addictive behavior is triggered the person is on a slippery slope, and turning back is unlikely without the tools of recovery. After a binge there may be feelings of remorse, shame, guilt, and anxiety, but those feelings fade when the person is triggered again.

Recovery from addiction begins with learning to recognize your triggers and having ways to help yourself avoid that slippery slope.  Compulsive behavior can be modified but addictive behavior usually needs to stop. Harm reduction programs try to modify addictive behavior but in my experience they are usually not effective after the initial excitement about the notion of being able to keep your addition but not letting it get out of control.  

There is a reason the 12-step programs’ focus on sobriety and community has proved to be effective for many people.  My goal is to be part of the community around the addict who is trying to live a healthy life.