The 12 characteristics most important in causing addiction, and in treating addiction
Any explanation of what addiction is, on closer inspection, raises further questions. “We are all addicted” is a popular notion that ultimately reduces the concept of addiction to absurdity, because nothing and no one makes a difference anymore. There are clear definitions in the ICD-11 and DSM-5 psychiatric diagnostic systems by which addiction disorders can be identified with some accuracy.
Addiction disorders are among the most common mental disorders in the population, and among men they are even the most common, above all others. However, not so much is known in the population and even in specialist circles about the causes of addiction and the treatment options. In addition to substance addictions, behavioral addictions must also be taken into account. The basic concept of addiction assumes a biopsychosocial causation.
The following are the 12 core characteristics that are most important in the development and treatment of addiction:
1. Addiction has many characteristics of a compulsion
More and more compulsive characteristics develop in thinking (desire) and in action (consumption). It is an acquired compulsion that can be weaned again. Impulsivity, the inability to renounce temptations, is as much a part of compulsive behavior as is craving.
2. Addiction often becomes chronic
For most sufferers, an untreated addiction takes the form of a chronic disease that causes lasting damage to the body, mind, psyche, behavior and social environment.
3. Change usually starts from the outside
Change usually starts from the outside, at least at the beginning of the process of overcoming addiction. Weaning requires external impulses (external motivation, see also here) and increasing inner effort and goal orientation (self-motivation).
4. Abstinence is a sensible and worthwhile goal of change
Abstinence is a sensible and worthwhile goal of change that can be achieved through one's own efforts, with the help of addiction self-help groups, counseling and therapy. If abstinence is not achieved or if other goals are in the foreground, especially reducing consumption, these goals can also be useful. It is crucial to break the vicious circle of loss of control, self-destruction and psychological defense mechanisms (denial, trivialization).
“For most addicts, cravings and consumption patterns are beyond their conscious control [… Overcoming] addiction requires mindfulness and self-reflection”
5. Addiction develops a strong dynamic of its own
Addiction develops a strong dynamic of its own which includes cognitive defense patterns such as distortion, trivialization, repression and ignoring (see also here). In everyday language there is often talk of lies and cover-ups. These defense strategies prolong the addiction process and lead to strong interpersonal conflicts in partnership, family and social relationships.
6. Cravings and relapses are not consciously controlled
For most addicts, cravings and consumption patterns are beyond their conscious control until they have overcome their illness. This applies to continued addictive substance use as well as recidivism. Overcoming the automatism of addiction requires mindfulness and self-reflection on the automated process.
7. Addiction is also a brain disease
Chronic substance use and the resulting addiction change the brain and with it thinking, feeling, perception and consciousness. The resulting behavior and experience is different than without the influence of the addictive substances. And this is precisely what is initially attractive about consumption for those affected. The same applies to excessive behavior that can lead to behavioral addictions.
8. Addiction affects the whole family
Addiction affects the whole family, often across generations. Addiction is rightly viewed as a family disease because everyone is affected (cf. this). Many addicts come from families with addicts, and the children of many addicts become addicts themselves. Biopsychosocial factors are responsible for this. In addition to genetic risks, living conditions, expected effects, sociocultural rituals and availability of the substances are relevant.
9. Addiction rarely comes alone
Because excessive substance use, like highly impulsive behavior, often has psychological functions such as compensating for (“getting away from”) negative emotions or mental problems, their development and maintenance are closely linked to mental disorders. In the beginning, substance use serves mostly as unconscious self-medication, as a result, addiction disorders reinforce existing mental disorders or create new ones. Addiction is thus closely linked to other mental disorders (especially in the areas of anxiety, depression, antisociality and personality). These psychological problems should not be treated separately from the addiction and vice versa (see here).
“Most substance addictions (alcohol, nicotine, opioids, stimulants) affect men three to four times as often as women.”
10. Addiction involves self-harm and harm to others
Long-term chronic substance use damages the body and psyche. Addiction involves a vicious cycle. First of all, increased substance consumption is about improving psychological discomfort, often only unconsciously, or about increasing well-being. Later, habitual substance use brings with it self-harm to the body and mind, as well as harm to others in relation to the family (partner and children).
11. Boys and men are particularly at risk
Addiction disorders can affect everyone, but the risks vary. Most substance addictions (alcohol, nicotine, opioids, stimulants) affect men three to four times as often as women. Most behavioral addictions (sex and porn addiction, gambling addiction) also affect significantly more men than women.
12. Personality traits can be dangerous or protective
Depending on personality traits, the risk of addiction varies. It is now clear that there is no one addictive personality that predisposes to the disease. On the one hand, ordinary values and emotional stability protect against addiction disorders. On the other hand, ego weakness, emotional instability, neuroticism, anxiety and depression are risk factors for substance abuse and, as a result, for addiction disorders.
Conclusion
These twelve basic facts about addiction disorders are a rough framework to aid our understanding. The need for research, targeted prevention and improved forms of treatment is immense. The reason for this is that the relevance of addiction disorders in the population is greatly underestimated. What the individuals affected have fended off and repressed for years is also a taboo at the system level by most of those responsible in politics, education and the health system. If you look at substance and behavioral addictions together, conservatively calculated, more than 8 million people in Germany are affected every year. Of these, about 70% are men, 30% women. It is worth investing more into prevention, education and treatment.
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Disclaimer: This article is for information purposes only and is not a substitute for therapy, legal advice, or other professional opinion. Never disregard such advice because of this article or anything else you have read from the Centre for Male Psychology. The views expressed here do not necessarily reflect those of, or are endorsed by, The Centre for Male Psychology, and we cannot be held responsible for these views. Read our full disclaimer here.
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hyper-masculine gender norms are typically embedded within military institutions, and while adherence to these norms can contribute to combat and military success, they conversely make clinical work challenging
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Michael Klein
Prof. Dr. Michael Klein, psychological psychotherapist in his own practice in Cologne. Author and expert in men's issues, mental health and addiction prevention.
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