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  The Addictive Process
Floyd P. Garrett, M.D.

The addictive process is a recognizable psychological and behavioral syndrome that expresses itself in a particular individual in regard to specific substances or processes but which exhibits a striking similarity and commonality among  addicted individuals regardless of their specific circumstances and particular addictions.

Addictions may be subdivided into:

Crossover, switching of addictions, multiple addictions and a changing pattern of addiction are common but not universal features of an underlying  addictive illness with recognizable structural features of its own. In depth understanding of addictive processes must begin with the general and common features of addiction and move to the specifics of the addictive expression in a specific individual. Whether the addiction is single or multiple, substance or process, legal or illegal or an unstable and shifting combination of all the above,  certain recurring and recognizable common features distinguish addictive from non-addictive processes.

Characteristics of the addictive process are: 

  • salience, obsession, abnormal or pathological importance of the substance or behavior
  • persistence, rigidity, stereotypy, inflexibility and repetition of the particular addictive behavior
  • relative immunity to adverse consequences and resistance to learned modification of behavior 
  • the invocation of an interrelated system of psychological defenses which, like a string of military forts,  function in concert to protect the individual from the full realization and acknowledgement of the self- and other- harmful nature of his addiction and hence provide cover and concealment for the continued expression of the addictive process.

Addictive fascination and fixity of interest have been justly compared to the more commonly known stage of romantic or infatuated love in which the lover thinks constantly of the beloved and pines and suffers when not in their presence. An individual in such a state of mind is said to be obsessed with their love object and to subordinate every other aspect of their existence, including at times their health, work, and other relationships to the fulfillment of the almost unbearable need and longing to be united with their beloved. And we know from life as well as literature that so passionate and  frequently desperate are such lovers that at times they even die as a consequence of or for their love. 

Anyone who understands the terrific drive and intensity that underlies and propels well-established addictive illness will not be surprised at the difficulties individuals encounter when attempting to control or terminate their addictive behaviors. In such situations the old saying 'The spirit is willing but the flesh is weak' is an apt description of affairs once the individual has reached the stage of recognizing his addiction and the need to do something about it. And in many if not most cases, such a recognition of harmful addiction may itself come only very late in the course of the addictive process, which has long managed by means of the psychological defenses mentioned above to conceal and therefore protect itself from the critical recognition of its host.

There are many paths and ways to recover from addiction but all require the capacity for honesty with oneself and the willingness and ability to bear the temporary but often intense discomforts associated with the loss of a love. And in almost all cases the recovering addict must find ways to replace what he has lost with new and healthier ways of relating and dealing with life. Simply stopping an addictive behavior by sheer force of personal will power is effective for some but certainly not all, and probably not the majority of the addicted population. Such frontal assaults on the addiction are not infrequently successful for a while - but if nothing else changes, the addiction is likely to reassert itself and perhaps in some cases grow even stronger.

The modern medical understanding of addiction is called the medical model of addiction to distinguish it from the traditional and still widely held moral model of addiction. Although scientific evidence is steadily accumulating incriminating physical, physiologic and genetic(hereditary) factors in addiction, in many quarters addicts are still viewed as weak, bad or immoral people. Worse still, that is the way the typical addict tends to view their own behavior. Ironically, the painful feelings of guilt, shame and fear resulting from the conflict of addictive behavior with the individual's own values often create  states of unbearable inner stress that make it harder for the addict to refrain from resorting for relief to the very addiction that is causing the negative feelings.

Addiction is now viewed by the scientific and medical community as a disorder of brain functioning that, like all other disorders of bodily organs is significantly influenced and impacted by a wide variety of personal, environmental, psychological and physical factors that may have nothing directly to do with the addiction itself but which indirectly may advance or retard its expression in behavior and also influence recovery or remission of the addictive illness.

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