When we talk about addiction, many of us immediately assume that we are referring to an alcohol or drug- related compulsion. The reality is that addiction involves so much more than the substance, or behaviour, of choice. It might surprise you, however, that although the resulting behavioral, physical and social implications of addiction differ, the mechanism of the addiction itself is the same.

How is Addiction Defined?

An addiction is a repeated pattern of substance use or behaviour that we continue to engage in despite its negative impact on our lives. While the destructive physical and mental fallout of some addictions are easy to identify, addictions can take many forms and the impact of some are much more nuanced – hidden to the untrained eye. For some, consequences of the addiction are not outwardly expressed, but inwardly (physically) experienced as health concerns. Consider, for example, the implications associated with a food addiction. While it may seem innocuous in the short-term, the reality is that food addiction can have drastic implications on physical and psychological wellbeing in the long-term.

Addiction and the Brain

Whether it’s drugs, food, shopping, gambling or sex, addictions are an indication of underlying distress. Overuse of substances or displays of compulsive behaviour  are coping mechanisms to move us away from pain and discomfort in the moment, without regard for the enduring consequences on our health and relationships.

While genetics may play a role in addiction, some experts postulate that genetic factors may have less to do with addiction than do the brain pathways and behaviours that arise out of a need to cope with dysfunctional environments in our early years. This is supported by the fact that when we are in a chronic state of distress, our brain begins to sensitize the neural pathways that reflect an elevated state of arousal.

Your brain ‘sees’ physical pain and emotional pain as being one and the same. That means that the same part of the brain lights up when you are injured while playing sports as when your heart aches with the pain of a loss or breakup. Whether a threat is real or imagined, imminent or historical, the brain sends the same signal.

To make matters worse, the brain frequently stores information about traumatic events in a disorganized manner. While some images are seemingly burned into memory, other memories are compartmentalized and stored in the survival portions of the brain where they cannot easily be accessed. Without our ability to bring these memories into the prefrontal cortex (the logical and planning portions of our brain), we may be left to suffer the emotional effects of the trauma without having a memory to connect to it. Feelings without facts are known as emotional flashbacks and are most often associated with events that occurred before the age of 5. Trauma that occurs later in life is more likely to produce vivid memories along with emotional flashbacks, as seen in PTSD. The distress caused by emotional flashbacks, with or without memory of the event, can give rise to the destructive coping mechanisms seen in addiction.

“…trauma isn’t what happens to you, it’s what happens inside of you.” – Gabor Maté

Therapy and Recovery

In the absence of memory, emotional flashbacks are often attributed to what’s going on in the present moment while overlooking the original source of the distress. For this reason, many clients arrive at their first therapy session with complaints of chronic depression and anxiety without knowing why.

Dr. Gabor Maté, one of Canada’s leading addiction and trauma specialists, brings powerful awareness to the discussion about trauma and addiction when he remarks “…trauma isn’t what happens to you, it’s what happens inside of you.”

Addiction is a vast and complex subject that stems from our desire to solve from the outside what is wrong on the inside. As a therapist, I offer my clients a witness to their story free from guilt, shame and judgment. As we work together to explore and process the emotions associated with our symptoms, we begin to bring self-compassion into the dialogue, and subsequently find relief from chronic shame. I urge my clients to approach therapy with an open mind and a willingness to really get to know themselves. This is no small task, and requires emotional literacy, vulnerability and a skilled therapist who can partner with you through this difficult process one step at a time. A new life awaits you as you step into recovery.