What are Process Addictions?

While the term ‘addiction’ is most commonly associated with substances, it has more recently been expanded to include a number of activities or behaviours, called process addictions.

Behavioural process addictions usually involve highly rewarding, reinforcing, natural drives – such as love, food, money and sex – which, in moderation, can be healthy and normal.

It is when we become overly reliant on a specific behaviour – using it to get ‘high’, to escape underlying issues and emotional pain, or to replace relationships or commitments – that it can spiral out of control, resulting in process addiction. When we lose control over the rate, frequency or duration of a specific behaviour – and the need to engage in the behaviour becomes greater than the consequences to our wellbeing – it is time to seek treatment.

Process addictions include:

  • gambling
  • sex and love
  • work
  • new technologies (the internet, mobile phones, online chat rooms, social media)
  • video gaming
  • shopping
  • eating
  • exercise
  • plastic surgery.

While process addictions do not involve substances, they do share some similar characteristics with drug and alcohol addiction, for example:

  • they initially produce pleasure
  • they provide escape or relief from emotional or physical discomfort
  • they involve powerlessness (i.e. an inability to resist temptation or impulse to engage in the behaviour)
  • they are unmanageable (i.e. engaging in the behaviour results in significant negative consequences)
  • cravings or urges to perform the behaviour are present
  • feelings of anxiety, stress or depression occur when we cannot engage in the behaviour (withdrawal symptoms).

Process addictions frequently co-occur with other addictions or mental health disorders.

Left untreated, a process addiction will have far-reaching consequences that not only cause damage to the addicted person’s life but may also impact negatively on the lives of their family, friends, work colleagues and extended community.

What are the Different Types of Process Addiction?

Some of the most common types of process addictions develop from behaviours that are socially acceptable, and can even include necessary behaviours such as eating, shopping and exercise. This can make it difficult to recognise when a behaviour has become more than just a healthy habit or pastime and has developed into an addiction.

Some of the most common types of process addiction include:

  • Gambling
  • In today’s society, gambling is easily accessible to everyone – in high street betting shops, online, casinos, at sports events, etc. For many, gambling is a harmless form of entertainment and poses no significant consequences or difficulties controlling their behaviour. However, like other impulse control disorders, for some people, gambling can become an addiction. The intense emotional high and thrill of winning have a can have a significant (and short-lived) effect on the reward centre of the brain – compelling some to bet again and again in order to feel the same intense thrill. Gambling disorder is often associated with co-occurring drug and alcohol abuse, depression and anxiety disorders – which need to be treated simultaneously.

  • Sex and love
  • Sex and love addictions are considered to be intimacy disorders and are primarily driven by a desire to control or escape from emotional discomfort – such as stress, loneliness, depression, anxiety or shame – using the intense rush / ‘high’ of sex, falling in love or romantic fantasy. They are both dominated by common factors, such as fear of abandonment, emotional pain and / or trauma, a history of childhood abuse, and an inability to cope with aspects of adult life in a healthy and functional way. Treatment often consists of participation in support groups and psychotherapy to work through the emotional issues underlying the addiction and develop healthy intimacy.

  • Work
  • In many societies, a compulsivity to work is often viewed as a good thing and is even actively encouraged. The stress and pressure of mounting deadlines and endless demands can cause some people to feel alert, awake and alive. In addition to providing for themselves and loved ones, work addicts are often driven by a need to succeed or achieve a certain status. They may also use work as an escape from emotional stress or difficult life circumstances. Work and achievement can create a feeling of pleasure, a short-term high, which for some people is highly addictive. A common result of work addiction is burnout. As with most process addictions, there are many treatment options for workaholics, including cognitive behaviour therapy (CBT), eye movement desensitisation and reprocessing (EMDR), and group therapy.

  • New technologies (the internet, mobile phones, social media)
  • Internet addiction is becoming widely recognised as a big problem, affecting large numbers of people all over the world, and is being given serious attention from many researchers and mental health professionals. The biggest challenge with this addiction is that we are constantly surrounded by technology and most of us use the internet daily. Just because we are regular users of the internet doesn’t mean we are addicted, but if it is damaging our relationships or other aspects of our lives, we need to seek help. The most common categories of internet addiction include gaming, social networking, blogging, online shopping and internet pornography use. Internet addiction can overlap with other process addictions, such as work and smartphone addiction. It can also co-occur with some mental health conditions, such as depression or social anxiety disorder. Treatments such as psychotherapy and support groups are proving to be successful in helping people to control and manage their internet use. 

  • Video gaming
  • Video games are specifically designed to be addictive, using state-of-the-art behavioural psychology to keep us hooked. There are two major types of video games and therefore two major types of video game addiction. Standard video games are designed to be played offline by a single player and involve a clear goal or mission. The addiction in these games is often related to completing a mission or beating a high score. The other type of video game addiction is associated with multiplayer online role-playing games (MMORPG). These are played online with other people and are highly engaging, using a variety of positive reinforcement techniques that appeal to our brains. The difference between a fun gaming hobby and an addiction is the negative impact the activity is having on our life. Research shows that MMORPGs are more addictive and tend to have greater negative impacts on physical health, sleep habits and daily functioning. People addicted to them often have increased emotional difficulties, including depression and anxiety, feel more socially isolated, and are more likely to have problems with substance use. Treatment comes in many forms, including different types of therapy or certain medications. It is important that treatment addresses any underlying issues, such as depression, to prevent relapse.

  • Shopping
  • Oniomania – compulsive shopping, or shopping addiction – involves compulsively buying new objects to produce a temporary high. It is used as a way to feel good and cope with emotional pain or avoid difficult life situations. However, these feelings are often short-lived and more and more purchases are needed to recreate the initial feelings of control and wellness. It can take over as an obsession, to the point that we continue to shop even when it is clearly having a negative impact on our life, especially financially. Shopping addiction often co-occurs with other disorders, including mood and anxiety disorders, eating disorders, substance use disorders, and personality disorders. Compulsive shopping responds well to a range of treatments – particularly therapies, such as CBT – that teach alternative ways of handling stress and address any underlying mental health disorders.

  • Eating
  • For those suffering from an eating addiction, highly tasty foods (often rich in fat, sugar, and/or salt) trigger chemical reactions in the brain that induce feelings of pleasure and satisfaction. This reaction can be similar to a drug addict’s response to their substance of choice, as it activates the same brain reward centre. Compulsive eating, where the need to feel good requires the consumption of more food, can lead to a range of physical, emotional and social consequences, such as digestive problems, heart disease, obesity and depression. Eating addiction is commonly associated with other mental or behavioural disorders, such as a range of eating disorders, obsessive-compulsive disorders and personality disorders. In some cases, a person with an eating disorder may also have a co-occurring substance use disorder. The treatment of eating addiction is complex and requires multi-specialty treatment in order to effectively heal and recover.

What are the Causes of Process Addiction?

As with any type of addiction, the underlying causes of process addictions cannot be easily identified as one single source or event. Studies support that process addictions are often the result of a combination of factors including genetic, biological and environmental. Underlying exposure to trauma, abuse, unhealthy relationships or high levels of stress can also contribute.

Researchers believe that substance addictions and process addictions share many common biological and behavioural characteristics, and therefore may share many risk factors that have an influence on their development, including:

  • genetics
  • personality traits
  • low distress tolerance – lack of healthy coping skills for easing stress
  • early exposure to trauma / abuse / neglect
  • a co-occurring mental health condition, such as anxiety, depression or PTSD
  • environmental
  • societal
  • an existing substance use disorder.

The factors that contribute to the onset of a process addiction are unique to each person, which makes predicting them almost impossible. However, it is now believed that several factors need to interact in order to trigger the onset of any addiction and that no two people will be affected in the same way.

What are the Signs and Symptoms of Process Addiction?

Many of the activities or behaviours involved in process addiction are deemed acceptable in society and therefore it can be incredibly difficult to recognise or acknowledge when a certain behaviour has developed into an addiction.

One of the key differences between a healthy enthusiasm for any of these activities and a process addiction, is that a healthy enthusiasm adds to our life while a process addiction takes away from it.

While the physical signs and symptoms of substance addictions are typically absent in process addictions, there are common mental, emotional and behavioural signs to look out for, including:

  • spending excessive amounts of time thinking about or engaging in the behaviour, or recovering from its effects
  • an increasing sense of tension immediately before initiating the behaviour
  • an inability to control the behaviour, despite being aware of the negative consequences
  • repeated failed attempts to reduce, control or stop the behaviour
  • prioritising the behaviour over other parts of our life, including family, work, friends and other responsibilities
  • giving up important work, social or recreational activities because of the behaviour
  • using the behaviour as a coping strategy to feel in control and / or deal with difficult emotions and feelings
  • secrecy – hiding behaviours from others, lying about them and / or downplaying the extent of the problem
  • developing a tolerance to the behaviour so that we need to increase the frequency or intensity of it, in order to achieve the same satisfaction
  • experiencing emotional withdrawal symptoms, such as moodiness and irritability, if unable to engage in the behaviour (can lead to developing mental health problems, such as anxiety, depression or substance abuse).

The signs and symptoms of any addiction can vary from person to person, depending on the type of addiction, and on individual circumstances. It is important to recognise that without expert help and support, the effects of a process addiction will become increasingly worse, resulting in a negative impact on all areas of our life.

Process addictions are treatable and there are a number of effective treatments available to ensure full recovery and prevent relapse.

How can Process Addictions be Treated?

Process addictions present some unique challenges in treatment options. Many of the behaviours or activities involved – such as working, eating, shopping and using the internet – are common and necessary parts of everyday life and so abstinence is not a realistic solution.

Effective treatment therefore not only needs to address the underlying issues, but also to provide recovery tools so that we are able to engage in the behaviours or activities in healthy and ‘normal’ ways.

Treatment plans for process addictions typically focus on behaviour therapy and include:

  • Individual therapy – to help us look deeper into the issues surrounding our behaviours, get to the root causes of these unhealthy coping strategies and learn alternative coping skills to replace them. Talk therapies, such as CBT, are known to be highly effective in treating process addictions.
  • Group therapy – to helps us explore the underlying issues contributing to our addiction, have an opportunity for honest feedback and open sharing, to understand how others deal with similar issues, and learn healthy communication skills.
  • Psychiatric care – as co-occurring mental health conditions can feed process addictions they need to be diagnosed and treated at the same time. Medication may sometimes be used to relieve any severe symptoms of mental health conditions while undergoing treatment. Each disorder needs to be addressed fully, along with any potential interactions between them.
  • Complementary therapies – complementary therapies can be beneficial during recovery, as part of a holistic treatment plan, such as equine therapy, mindfulness, music and art therapy, and acupuncture.
  • Aftercare – ongoing support is hugely important for relapse prevention in process addictions, so an aftercare plan is needed, including access to local support groups.

Process addiction treatment plans will depend on each individual’s specific needs. An experienced therapist will have to assess the situation and the addiction – along with any co-occurring conditions – and determine the most effective treatment plan for each unique set of circumstances.

By asking for help, and participating in a therapy programme designed just for us, it is possible to overcome any addiction and start building a healthy, happy life without it.

If you or a loved one are struggling with a process addiction and need help, effective treatment is available. Please call us now so we can help you discover a treatment plan that will work for you, so you take back control of your life.

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