By Johanna Sartori, Integrative Psychotherapist at The Priory Hospital Woking.

What leads some people to become addicted, when others don't?

Current thinking points to the role of genetics, environment and brain chemistry amongst other factors, but one way of looking at causes is through the idea of addiction as a feelings disease.

A recent Addiction Therapy Programme (ATP) group discussion on when alcohol first became a part of our patient's lives, revealed a common experience of drinking to fit in at university, and to make it easier to feel part of social activities. What these patients shared was an experience of anxiety they did not know how to manage and which threatened to overwhelm them. Having a drink seemed to take the anxiety away and give them more confidence, allowing them to socialise and function in social gatherings. Over time, the anxiety is hidden as long as alcohol is available and the individual therefore never has to manage or process the original difficult feeling. They do of course have to keep drinking to keep the anxiety at bay. The patients in this discussion were talking about early adulthood and the transition from childhood to adulthood is often associated with stress and heightened emotions. Not surprisingly, drug and alcohol use at this time is a key factor in the development of addiction.

How addiction takes over your life

It is not just anxiety, however; anything that feels intolerable can be blotted out with drugs or alcohol. Sometimes it is a memory of trauma or abuse that the individual cannot bear and they have to find something to keep it pushed down. Often, a very early emotional injury can be outside of a person's known memory but at a very basic level, there is still a need to block out the possibility of this memory surfacing.

Whilst alcohol or drugs may initially represent a quick and effective way to get rid of the unbearable, a cycle is quickly established whereby there has to be a constant access to the drug of choice for the individual to feel that they can cope. The ability to manage feelings - to self soothe - already compromised, ceases to exist altogether in the addict. After time it becomes increasingly difficult to recognise or feel any emotion, other than the preoccupation and desire for the drug of choice. It is estimated that around 50% of alcoholics suffer from Alexithymia, which is a clinically recognised state of emotional unawareness and a difficulty distinguishing between feelings and bodily sensations.

How addiction affects your life

Patients often come into treatment thinking that recovery is about putting down the drugs or alcohol, when in fact, as the AA Big Book says, recovery:

"could have little permanent effect unless at once followed by a strenuous effort to face, and be rid of, the things in ourselves which have been blocking us".

Being in treatment and recovery therefore means reconnecting with a whole host of feelings and emotions, which patients on our treatment programme often say can feel very intense once they are no longer drinking or using. If you think back to being a child and your earliest experiences of feeling happy or sad or scared, such feelings seemed to take over your whole being, until you learn to manage it, and this is much like being in early treatment. Alongside this, the partners and families of our patients often complain that in their addiction, their loved ones were selfish and self-centred, and difficult to talk to. Being in treatment and recovery also then means re-learning how to navigate these relationships in a positive way. This is why we involve families in treatment, both for the patient's benefit and also to support their loved ones who have a raft of their own feelings to process.

So, whilst there are several contributing factors to addiction, and more and more is becoming known about the neuroscience of addiction; at a grass roots level, addiction is a feelings disease.

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