Different Stages in an Addiction Cycle

Over-medication and vulnerability

First, I need to make a couple of general points about labelling what people do when they overuse or over-do anything as an “addiction”. The same goes for labelling the person as an "addict" This is too easy a way out. What we should be doing is describing the person more accurately as someone who:
1. Is suffering from deep emotional pain, or emotional wounding usually carried from childhood. What they are doing in the short term is medicating, usually over-medicating, their emotional pain, as I explain below. There are some who claim that addictions are inherited and that is true in a small number of cases. But I have never yet met a person in an addictive cycle who deep inside wasn't greatly troubled by emotional pain or emotional wounding. What is described as their addiction is whatever they find helps medicate their wound or reduce their pain.

You will notice that when I write about addictions I use the term "medicating" a lot, mainly because this describes what is happening inside that person far more accurately but also because this is less likely to invoke some of the feelings of shame that a person feels whenever they are labelled as suffering from a bad disease, a bad habit or lack of willpower. It is no coincidence that usually the deep emotional pain or wounding has a very strong shame element within it, so shaming makes the pain worse.

2. Is in denial. Which is a rather judgemental way of saying that while they are under the influence of their particular medication (their addiction) and, or while they are suffering from deep emotional pain, it is impossible for them to see clearly what others can see them doing. Usually they are in one or the other state, which is why it's often said that all addictions involve denial.

3. Is trapped in "an addictive cycle" because this is really what is happening inside them.
I have written about this on a separate page and described the various stages in the cycle which people we like to call "addicts" are really going through as they get trapped further and further into their addictive cycle.

Below, I describe the various stages in the cycle which people we like to call "addicts" are really going through as they get trapped further and further into their addictive cycle. .
As I explain there someone trapped in an addictive cycle is not a "bad" person, even if the things they do are very wrong. They are not giving in to a "bad habit" which they could easily overcome with a little willpower. Even if they could stop medicating they would still have the emotional pain and in many cases that is unbearable.
I also have a personal rule that no one has the right to label anyone else an "addict" unless they acknowledge that they too are one and therefore have some real understanding of what is going on, so at that point I need to go on record here and acknowledge that I too am a recovering addict, from not one but several different forms of medication. I too spent many years trapped in my own addictive cycles. It and it took some amazing people in a number of different Twelve step groups, and some absolutely wonderful addiction counsellors to teach me how to get out of the trap and free myself from the cycle. By the way, as any recovering addict will explain to you I may be in recovery but I will never be free of the addictions themselves. The day I believe that I am free of them is the day they will return.

What is medicating?

1. Using external substances like alcohol, nicotine, sugar or illegal substances which in turn produce brain chemicals which relieve the emotional pain. Go to Overview of Addictive Substances and Activities
2. Medicating on internal substances. These are brain chemicals and hormones produced by the body as a result of physical activities, for example gambling, excessive exercise, work-holism, anorexia, bulimia, and co-dependency to name a few. In each case the person has found that for them one specific kind of activity encourages their body to produce special, make that very special chemicals which help reduce their emotional pain. It's important to note that these do-it-yourself body chemicals relieve emotional pain far better than any external substance. They are also highly addictive. Go to Overview of Addictive Substances and Activities

It is normal for people to try to reduce their pain so there is nothing essentially wrong if someone is trying to reduce their emotional pain. A person experiencing severe emotional wounding or anxiety is extremely vulnerable and will do whatever they can to block it. When the helpful protector characters in your inner village (inner selves) run out of ways to reduce the hurting and the next thing is to try substances or processes from outside the village. At first these often seem to work almost miraculously, so the process is repeated more and more often. But sooner or later the treatment starts to lose its effectiveness.

What is described as "an addiction" exists when someone finds themselves trapped in a cycle in which he or she keeps increasing the amount of their (external) emotional pain reducing medication. They are doing this primarily because they are chosen medication is not working as well as it did at first. One of the features of all addictive cycles is that at first their pain reducing powers appears so miraculous that even when this starts to lessen the individual or fully expects it will soon start performing miracles again. So, rather than the term ‘addiction’ it would be more accurate to describe what is happening as a cycle that is happening inside a person in the place we describe as their inner village.

In the same way, the person we typically call an addict could be more accurately described as someone who is ‘trapped in an addictive cycle’. The addictive nature of the cycle is made worse as he or she starts suffering side-effects caused by their emotional pain-reducing "medication", yet is unable to stop taking it and is still expecting that soon it will soon begin performing miracles once again.

The last thing needed at any point is for anyone to use a shaming and inaccurate term that labels the individual as for example an ‘addict’; "substance abuser" an ‘alcoholic’ or judges them as a ‘bad’ person who has selfishly adopted a ‘bad habit’ . Worse still is the shaming assertion that if the individual was a "good" person they would easily be able to get rid of their "bad habit". Shaming of this kind often does irreparable harm and makes the addiction much harder to handle.

It would be far more helpful, for instance, to recognise that they are a person who is trapped in the grip of an addictive cycle, and, at the same time, help them to become aware just how much they are suffering serious side-effects from over-using their emotional pain reducing medication.

An addictive cycle

A person who is likely to get into an addictive cycle goes through several distinct stages:

Stage 1 - Moderate medication - not yet an addictive cycle (trial period)

1. Increased emotional pain - Something happening in the person’s life triggers their emotional pain and their need for some way of reducing it. Examples include increased feelings of anxiety or vulnerability, resulting from the loss of a job or a failed relationship, abuse of any kind or just the painful experience of entering adolescence. The event may also lead to feelings of increased guilt, fear, loss, shame or a deeper sense of being to blame. Any experience that leads to loss of self-esteem or spirit, or a connection to polarised negative core beliefs will have the same effect, that is increasing the level of emotional pain.

2. Failure of previous ways of adapting - from early childhood all of us have developed useful behaviours that involve adapting or changing something about us. That change helps us to fit in with other people so we keep repeating it until it becomes firmly established as no longer "change" but a permanent part of our personality. Sometimes, however these previously successful protective behaviour patterns stop working or their effectiveness. Those hard-working inner protector characters, inner protector characters or adapted inner selves inside us may still be trying as hard as ever but they are no longer getting the desired results

3. Trying something outside me - one day just when our inner characters (inner selves) seem to be losing their protective power we are amazed to discover a magical substance, an activity (or another person) which can take their place and at first, it seems to work better than our inner protector is ever did. At that moment it seems like a good idea to stop trying to cope with life's problems from within and let something outside of us take over the job.

This new external form of adaption or ‘medication’ usually does work better for a while. The initial effect of all medications is to provide some alteration in mood or energy levels. This can include:

* Relaxation

* Stimulation

* Mood moderation (more relaxed, more joy, less shy, more confident)

For some fortunate people this is as far as the external medication process goes. They find an acceptable dose rate and follow it. Their medication might be a cup of coffee at morning tea time, a glass of wine in the evening, a sedative to help with occasional sleeping problems or a few drinks at a party.

Unless they progress to Stage 2 they will not become trapped in an addictive cycle. They may still have to face three problems associated with any medication

1. They need the help of something outside them to cope with something inside them; so if they run out of it they will have problems

2. Using even moderate amounts of the medication may have unseen side-effects.

And this is the big one

3. The miraculous pain reducing powers of the medication get less and less over a period of time. The person using it will build up a tolerance.

If however, using moderate amounts appears to produce "improvements" like those below, the person will connect these with their use of the medication. This in turn will encourage them to increase their use of that medication. (If two drinks make me feel less sad, six should make me really happy.)

Early changes during the Stage 1 or trial period that encourage heavier use include:

* Mood reversal (Example - low to high, nervous to super-confident, sad to super-happy, shy to over-confident))

* Feeling much higher self-esteem, great happiness and joy or just ‘so much better’

* Improved perception of life (my friends/work/relationships/car driving/sex life/ dancing/ even my reality etc. suddenly got so much better)

* Reduced emotional pain or anxiety

Stage 2 - Increasing use of medication

4. Increasing need to use their medication combined with build-up of tolerance - If a medication works well and people feel much better whenever they use it, it’s normal to develop an increased appetite for it. At the same time, as with any pain reducing medication if it is being used repeatedly, a tolerance develops. The longer you use it, the more you need and the more often you need it, in order to get the same reduction in pain or anxiety.

Stage 2 is triggered by growing feelings of anxiety or vulnerability, more guilt, fear, shame, blame, greater loss of self-esteem or spirit. Pia Mellody describes the emotional pain at this stage as becoming ‘intolerable’.

5. Rationalising - The person using the medication suggests reasons that (to them) appear to be completely logical and rational. Their "reasonable" arguments are often presented to support or justify their increasing use of their chosen medication. Example: "I just enjoy the taste of it" "It just helps me relax" "Everybody needs at least one little vice" "There is no evidence to show that it does any harm." "Other people might be addicted but I am not like them." "It’s because you nag me about it so much. That only makes me need it more often!" To the outside observer these reasons may not be nearly as convincing as they are to the person who expresses them.

6. Denial - This is really just a more extreme version of rationalising as described above. The reasons offered are often quite bizarre and to observers far from convincing. In extreme cases the individual may deny that the events that took place ever occurred or claim that they have been exaggerated out of all proportion by biased observers. Example: "So what? It didn’t do any harm and nobody got hurt." "No, that never happened." "Somebody is making up stories about me." "I am totally in control, I can take it or leave it." "I can give it up any time I want to."

7. Withdrawal Issues - If a person can’t get their medication they sometimes find themselves having to have to face their ‘intolerable pain’ again.

Withdrawal symptoms when the person is unable to get their medication are among the first observable signs of a developing addictive cycle.

8. Stashes and backup supplies

To avoid the pain of withdrawal they start to organise a secondary source they can call on if their usual supply runs out. This stage in the cycle is another of the first noticeable signs as the individual starts organising ‘backups’ or ‘stashes’ (open or hidden) in case they cannot access their usual supply.
A heavy drinker start hiding bottles of alcohol in cupboards or out of the way corners or in the boot of their car. A smoker hides packets of cigarettes at the backs of drawers or cupboards and also keeps a spare packet in the glove box of the car. Gamblers used to have hidden stashes of cash but with the advent of the automatic teller machine their stash is conveniently available via a piece of plastic. You may however observe that the gambler has several spare pieces of plastic in case one doesn't work. That is their present day stash. Sex addicts may keep a string of partners available so that one is not able to help with their medication they can simply go to the next one. Workaholics take their work home with them and insists on taking their laptop and mobile phone when they go on holidays "in case of emergencies". If the factory, shop or office doesn't ring them you can be sure that they will be ringing someone at work.

9. Side-effect problems - The more I use any medication the more serious the side-effects. Typical effects from overuse or extended use of emotional medication include:

ê reduction in everyday skills and abilities

ê reduction in moderation and ability to balance polarised inner protector characters, inner protector characters (inner selves)

ê health problems directly due to overuse of the medication

ê losing touch with reality including increased denial about these side-effects

ê less awareness, inner protector characters (inner selves) more in control of life

If someone you know (or if you) reach this stage, (pointers 7 to 10 above) it is time to start describing the process as ‘addictive’ because from here on it becomes much harder to stop the cycle.

Stage 3 - Over medication

10. Problems from over-medication now make original problem worse - The side-effects listed above cause an upsurge in the original feelings of anxiety or vulnerability, guilt, fear, shame, blame, loss of self-esteem etc. that led to the use of the medication. The worse these feelings, the more medication is needed and the greater the damaging side-effects. The addictive cycle now tends to move faster and is much harder to stop.

Stage 4 - Major breakdown or recovery

If the person continues to increase their rate of medication the cycle goes one of two ways from here. Either they reach a point of total breakdown (often called hitting rock bottom) followed by recovery or they continue the cycle until it ends in an early death.

11. Increased overuse of medication results in major losses - Additional side-effects (listed above) all become worse. In particular reduction in everyday skills and abilities; loss of ability to balance polarised black or white thinking inner protector characters (inner selves) and health problems all become severe.

12. Deception, intentionally dishonest denial

The loss of touch with reality becomes more extreme. Denial now becomes deception (intentional dishonesty). Shame about what is happening leads to increased deceit.

Regardless of the substance or process involved these three pointers are almost always present and so help identify the stage the person has reached in their cycle.

Relationships with friends and family start to suffer severely. A person in the grip of their medication at this stage in the cycle is unable to have a functional relationship with any other human being. Their only significant "relationship" is with their medication. No one else really matters. This leads to massive problems including loss of jobs, loss of family and ultimately threatens their life.

Friendships are lost too, with the exception of fellow medicators who stay on, though there is no way at this point, that they can be classed as true friends.

Treating addictive cycles - do’s and don’ts

Do’s – only one

There s only one effective treatment for any addiction where the individual is medicating their deep emotional pain, shame, guilt, fear, loneliness or any strongly negative emotion. That is to increase the person’s ability to reduce, (and that means to reduce permanently) the pain, shame, guilt or whatever it is that is the driving their need for emotional pain reducing medication and their over-use of that medication.

Twelve Step programs such as Alcoholics Anonymous deserve to be recognised as one of the foremost successful treatments for all addictive cycles. Although their format remains incredibly simple and each group is conducted entirely by untrained volunteers, that group will include a number of people who do understand a great deal about teaching addicts how to reduce their emotional pain or wounding. And that is because they have had to do the same thing themselves and have managed to do it with some long term success.

The 12 Step program is effective because the group members are the best of all models and teachers for recovery - they are all people who have acknowledged their own problems with over-use and are successfully recovering from their own addictive cycles.

The groups are far from perfect but they have the reputation of getting more people out of addictive cycles than any other form of therapy or treatment.

There are now nearly two hundred different kinds of Twelve Step groups (each based on the particular substance or process involved - alcoholics anonymous, gamblers anonymous, co-dependents anonymous, over-eaters anonymous, debtors and spenders anonymous, rage-aholics anonymous, drama addicts anonymous, to name just a few) All of them enjoy a level of success seldom matched by treatment centres or expensive therapy.

A sample ‘Twelve Steps for Dependents Anonymous’ is included on a separate page.

Recovery programs such as those offered at the South Pacific Hospital in Sydney, the Currumbin Clinic on the Gold Coast and The Meadows in Arizona, all achieve very good results but need to be followed by regular work with a therapist and group meetings for several years, perhaps for the rest of that person’s life.

Recovery Don’ts

1. Do not shame, do not blame and do not make the person feel guilty. This one "don’t" stands out above all others. The person is over-using their medication because they found that despite the negative side-effects it at least gave them some temporary reduction in the their overwhelming shame, guilt or pain. Instead of reducing the over-use, increasing a person’s feelings of guilt and shame drives the addiction cycle further and faster. An addictive cycle cannot be reduced by shaming.

2. An addictive cycle is not a ‘habit’ and it cannot be broken by "will power". The only effective treatment is one that heals the deep emotional core pain and that may need to continue for the remainder of one’s life.

3. Never ask or expect an addicted person to ‘promise to give it up.’ The cycle they are in renders them incapable of the adult behaviour needed to honour such a pledge. I suspect the person asking for such a promise is also being less than adult if they believe it.

4. There is no ‘fast treatment’. People may ‘sober up’ overnight, using will power, but that just means that a more powerful one-above inner protector character (inner self ) has stepped and taken temporary control the medicating and enabling characters (inner selves). Any ‘rapid’ recovery, that involves the individual simply switching to a new medication, for example, from alcohol to chocolate or from gambling to increased smoking and drinking for example is not sobering up at all. In most cases it will only last for a few months. Or the new medication will simply take over from the old one on a long-term basis.

5. Any reduction in an addictive cycle based on punishment is only temporary. It’s much the same as if you had a really bad back injury and needed to take eight aspirin a day to block the pain.

Some concerned friends might consider this as evidence that you were addicted to aspirin and with the very best intentions might use some form of punishment to force you to stop taking aspirin. Your friends might then congratulate themselves that with their dedicated help you had beaten your aspirin addiction.

But you would still have the backache and you would still have to cope with pain. As long as the pain in your back is greater than the pain of the punishment, understandably, you will soon be back on the aspirin again.

FOOTNOTE: All addictive cycles are connected in some way to brain-altering chemical substances. In the case of process addictions like gambling the only difference is that the chemicals are produced within the body.

In both cases the end result is that adult awareness and the more functional moderate protector characters in your inner village are constantly being anaesthetised by the particular chemical and so that they have no chance of helping.

See also

Overview of Typical Addictive Substances and Activities

Inner selves and addictive Cycles

This could hurt a bit.....

The path and the holes - a story about recovery from addictions

Sex addiction

Example of the Twelve Steps (Dependants Anonymous)

Remember to H-A-L-T Hungry? Angry? Lonely? Tired?

Feedback - please e-mail me John Bligh Nutting - at nutting@growingaware.com

Don't worry about these copyright notices at the foot of each page. It just means I want to hang on to legal ownership of what I write for use in future books. Until that day, please feel free to copy and even adapt them for your own use and for friends as long as you acknowledge me as the author and owner of the copyright and you don't charge anyone for them. If you want to use them professionally or commercially (charge a fee for them) or for clients, each sheet you hand out must include full acknowledgment of copyright ownership as above and if you are benefiting as a result, I would appreciate an appropriate sharing.

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