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I am a counselor who works with a lot of people suffering from chronic substance/behavior misuse (i.e. addiction). check out the work of Dr Gabor Maté. addic

I am a counselor who works with a lot of people suffering from chronic substance/behavior misuse (i.e. addiction). check out the work of Dr Gabor Maté. addiction is much less an intrinsic property of a substance and has much more to do with a combination of personal factors like upbringing, ACEs (adverse/traumatic childhood events), modeling, and some genetics. it is not uncommon at all for someone to try an “addictive” substance like, say, cocaine, and never feel a pull to ever take it again.

filoeleven 5y ago
Do you have insights/opinions on the difference between physical and psychological addictions? Everything I’ve read draws a distinction between the two, though not any hard-and-fast rules. I’m especially curious about your take on things like nicotine or caffeine, which are generally considered to have more physically-addictive properties, whereas cocaine in my readings lies more in the mentally-addictive space (strong sense of motivation and empowerment and maybe invulnerability) up to a certain point. Anything from shopping to SCUBA to hoarding can be psychologically addictive, so it seems like a much broader range of activities that is more affected by personal factors, whereas a physical addition is a craving/habit of the body. But I have no personal experience of viewing these in lots of people or from a trained counselor’s perspective.
- palimpsests 5y ago
  The line you describe is quite blurred. A person without the "causes and conditions" for addictive behaviors can take a substance that is highly physically addictive, like nicotine, and still never have an urge to use it again. Most people know quite a few folks who have tried cigarettes once and only once. An addictive pattern originates as a survival resource - it starts out as a helpful coping mechanism: "X makes me feel better, helps me to get through life". It doesn't matter what it is - heroin, shopping, gambling, nicotine, etc. When someone starts taking the steps in their lives to learn new behaviors and break this cycle, the physically addictive properties of a substance are definitely relevant and need to be taken into consideration (consider things like alcohol or benzodiazepines which can have lethal withdrawal symptoms, depending on intensity / history of use, and will thus require medical support). Otherwise, the underlying treatment model will be identical. Also, consider that psychological symptoms can and will manifest as physical symptoms, and vice versa. I've witnessed incredible physical withdrawal symptoms as a result of unwinding "psychologically" addictive patterns like gambling or sex (night sweating, panic attacks, insomnia, GI issues, to name a few).

filoeleven 5y ago

Do you have insights/opinions on the difference between physical and psychological addictions? Everything I’ve read draws a distinction between the two, though not any hard-and-fast rules. I’m especially curious about your take on things like nicotine or caffeine, which are generally considered to have more physically-addictive properties, whereas cocaine in my readings lies more in the mentally-addictive space (strong sense of motivation and empowerment and maybe invulnerability) up to a certain point. Anything from shopping to SCUBA to hoarding can be psychologically addictive, so it seems like a much broader range of activities that is more affected by personal factors, whereas a physical addition is a craving/habit of the body. But I have no personal experience of viewing these in lots of people or from a trained counselor’s perspective.

palimpsests 5y ago
The line you describe is quite blurred. A person without the "causes and conditions" for addictive behaviors can take a substance that is highly physically addictive, like nicotine, and still never have an urge to use it again. Most people know quite a few folks who have tried cigarettes once and only once. An addictive pattern originates as a survival resource - it starts out as a helpful coping mechanism: "X makes me feel better, helps me to get through life". It doesn't matter what it is - heroin, shopping, gambling, nicotine, etc. When someone starts taking the steps in their lives to learn new behaviors and break this cycle, the physically addictive properties of a substance are definitely relevant and need to be taken into consideration (consider things like alcohol or benzodiazepines which can have lethal withdrawal symptoms, depending on intensity / history of use, and will thus require medical support). Otherwise, the underlying treatment model will be identical. Also, consider that psychological symptoms can and will manifest as physical symptoms, and vice versa. I've witnessed incredible physical withdrawal symptoms as a result of unwinding "psychologically" addictive patterns like gambling or sex (night sweating, panic attacks, insomnia, GI issues, to name a few).