Introduction. What are behavioural addictions?
In recent years, the term “addiction” has expanded to include extreme behaviours beyond substance use disorders. These behavioural addictions such as gambling, sex, food, Internet addiction and compulsive buying have gained recognition for their negative impact on people’s lives. Research suggests a strong neurobiological link between pathological gambling and substance use disorders. Currently DSM 5 reclassified only gambling disorder as the first and only behavioral addiction. Other behavioral addictions are still in the research stage, but their “diagnostic upgrade” will follow soon.
Social and psychological consequences
Behavioural addictions have detrimental effects on the individual and their families, resulting in negative emotions such as shame, guilt, fear, irritability, sadness, and anxiety. At times there are also catastrophic financial consequences, e.g. gambling and shopping addictions. In other cases, when behavioral addictions consume an inordinate amount of time, people will neglect their daily responsibilities, such as homework or parenting. Frequently, patients seek treatment to reduce negative consequences rather than modifying or stopping the behaviour altogether. Clinicians can assess when excessive behavioral patterns require intervention with psychiatric and psychological care. Ideally, the patient has insight and wants to end the suffering imposed by the behavioral addiction. Otherwise, caring friends, family members, or colleagues will have to nudge the addict along to reach out for professional treatment. As is the case in chemical addictions (alcohol or drugs), denial is what stops people from getting needed treatment.
Treatment of behavioural addictions
The therapeutic alliance is critical in addressing behavioural addictions. Building a relationship with the patient is key to understanding the full clinical picture. Patients must understand that the behaviour is not defining but rather a symptom of an underlying issue.
Exploring destructive patterns of behaviour and psychoeducation helps patients engaging in treatment. Empathy, hopefulness, and a flexible approach can lead to improved treatment outcomes. Psychotherapy, both individual and group, provides the best results. The 12-step program used in the treatment of substance abuse, also turned out to be effective treatment of behavioural addictions. However, the behavioural addictions are frequently comorbid with depression and anxiety. In such cases psychiatrists can provide supportive treatment with medication targeting the comorbidities.
Behavioural addictions. Conclusion
The recognition of behavioral addictions has broadened our understanding of addiction beyond substance use disorders. It is crucial to ask the right questions and build a therapeutic alliance to address these complex and subtle patterns. Through psychoeducation, exploration of ambivalence, and a flexible approach, clinicians help patients understand the root of their behaviour. In the second step the therapist can implement a treatment plan providing patients with the tools necessary to overcome the destructive behaviour leading to happier and meaningful lives.
Dr. Annette Schonder
Clinical Counsellor,
Marriage Therapist, Hypnotherapist
(American Board)
Call +971 4 457 4240