Understanding Addiction: Lessons That I Have Learned From Working With Addicts


Most of us know someone directly or indirectly has been affected by substance abuse or addiction problems. Understanding why someone abuses substances or becomes addicted is very complicated because unlike depression or anxiety there is a belief that there is a choice, a choice not to use and to begin using in the first place.  

 As an addiction specialist and psychotherapist, countless times I have heard family members, partners and friends of addicts say, "How could she choose the alcohol over me?" or "He became a different person and nothing else other than getting high matters to him."  

It's true- addiction is a beast that can overtake a person.

However, here are some things that I have observed working with addicts that might help you understand why someone has the need to numb in the first place.

1. UNRESOLVED TRAUMA: People often use substances to numb and/or escape from pain. Addicts are typically people who are extremely sensitive to their environment. They are able to pick up on other peoples emotions, motives and authenticity very quickly. They tend to be very emotional and reactive. Often this is caused by hyper-vigilance due to unresolved trauma. Being aware of their environment may have been a "survival mechanism" which helped them cope in the past. The constant feeling of being "on" all the time, is too much to handle. Imagine going through life that way... it's exhausting. This is why many people turn to an outside source such as drinking, Xanax, gambling, sex, etc. to find a release and "turn off" the pain. At first, it could just begin with recreational use to "ease the stress/pain", but it can quickly spiral into dependence or a full-blown addiction. 

2. PERSONALITY TRAITS: You have probably heard the term "addictive personality". It is a controversial label that many people do not agree with. However, in my experience, there are some common traits that many (not all) addicts share. Some of these traits may be attributes of their personality and others may not, but there are a few common characteristics that I have observed.

Some of those traits are: 

  • Taking things to an extreme (whether it's working overtime, dieting, starting a new hobby, playing video games, shopping- it's doesn't matter, it is always done in an "all-or-nothing" way). 
  • Internalizing feelings (shame, guilt, fear, self-blame and low self-esteem. Feeling inadequate or hopeless about oneself, others, situations and lacking the ability to express those feelings too others).
  • People pleasing/social anxiety (relying on alcohol or other substances to feel comfortable around other people or needing a buffer to feel "normal" in new situations).
  • Avoidance (dismissing or "holding in" feelings and disowning emotional, spiritual or relational needs and trying to numb or avoid them instead). 

3. LOW SELF-ESTEEM: Low self-esteem and addiction go hand-in-hand. Addicts often are riddled with feelings of shame, guilt and self-loathing that stem from their childhood, mistakes they have made and/or the pain that was caused to the people that they love by their actions. Sadly, the way that they often cope with those negative thoughts and feelings is by using and numbing more- which creates a destructive and self-sabotaging cycle that feels like it never ends.

4. PHYSICAL DEPENDENCE: What many people do not know is that there comes a point when substance abuse can turn into physical dependence. What this means is that the addict builds up a tolerance to the substance and begins to require higher doses to get the same "buzz" as before. Over time, the body many begin to get so used to the substance that it begins to depend on them, just like food, air, and water. Essentially, the person needs to use in order to function or they are at risk of withdrawal, which is extremely dangerous and painful. 

5. IDENTITY: Addiction or substance abuse can often become a part of a person's identity. As awful as the addiction can be, picturing a life without it can feel very vulnerable and scary. Drinking, gambling, drugs, shopping even sex addiction...  can become enmeshed with one's sense of "self" and it can be really hard to let it go.  "I've always been the guy who binge drinks and does stupid stuff in my group of friends," "shopping has always been my outlet when I am stressed out," "I have always been known as the drug dealer... If I am not that, then who am I?"   It's hard to recognize, gain insight and want to find a new identity, especially if the addiction has been a part of one's life for a long time.