There tends to be a negative view of addiction, especially sex addiction. This can even be the case with therapists who don’t have much addiction training! It can be difficult to understand the addiction struggle: why people continue to repeat behaviors they know will lead to negative outcomes. In the first part of this blog series, as I engage in training to become a Certified Sex Addiction Therapist through the International Institute for Trauma and Addiction Professionals, I would like to share my new understanding about the addiction cycle. I also want to show how it fits into an overall addictive system. The cycle and system referred to in this post come from Dr. Patrick Carnes’ Facing the Shadow (2015). The benefit for readers to understand the addictive cycle is to bring greater awareness and empathy to those in recovery, who by nature of addiction, unintentionally repeat negative coping tools in order to navigate the complexities of life.
Let’s begin by talking through the addiction cycle. Click here to see a visual representation of IITAP’s eight-step model. It looks like a figure eight, with two sub-cycles, each of four phases. Look at the bottom of the figure eight first – this is what the medical model calls the “brain disease” of addiction. In this sub-cycle, an individual’s brain has become so accustomed to the substance or behavior that it expects it. In addiction language, this is called tolerance. The sub-cycle consists of four phases: preoccupation, ritualization, acting out, and despair. To describe the phases, I will use the term addict. Preoccupation is when one will have constant thoughts about what he/she is addicted to. Whether it’s food, sex, spending, gambling, alcohol or substances, there are consistent thoughts about how to get what they are craving. Then a ritualization phase starts where one will go through specific steps that make it more and more difficult to say “no”. He/she may open the app or the website or drive down a certain street. The addict does anything he/she can to get so close to the addiction. Then they aren’t able to resist giving in, and they act out. When one acts out or gets what he/she is craving, there is a hormone (dopamine) that releases in the brain that is very satisfying. For a moment, the brain got what it wanted. Once that feeling subsides and the individual realizes that the high is not fulfilling his/her underlying emotional/relational needs, the despair sets in. This is a moment they didn’t want to have again. It can be a very lonely, dark and scary place. After a period of time, the cycle resets and the preoccupation begins again.
When we are looking at the addiction cycle, we tend to only see the behaviors with which the person is struggling. However, the addiction cycle fits into a larger addictive system. This is the first sub-cycle in the overall model presented by IITAP, which again, you can find here. Look at the top sub-cycle now, with the first four phases: negative core beliefs, impaired thinking, addictive cycle, and unmanageability. The system starts with an individual’s belief system. The belief system informs how the person feels about themself, how he/she interacts with others, and even what his/her most important needs are. Trauma can play a key role in a person’s negative belief system. In several therapy models, it is important to identify and work on shifting this negative belief system. If the person feels unworthy, believes that no one cares about them, and considers the thing they are addicted to as their most important need, the system will continue to function how it always has. The belief system leads to impaired thinking. While thinking is impaired, reality is warped and awareness of the self is skewed. The impaired thinking paves a path for the addiction cycle to begin. As one continues the circle of the addictive system, the final phase is unmanageability. This is where one notices the consequences of the addiction cycle and the problems that are occurring, but has no idea how to stop it. The system circles back to the belief systems, only reinforcing the negative perspectives from which the addict started.
Addictions are difficult to manage, and it can be so difficult to help those who are in this cycle. Below is a list of resources. If you or someone you love is caught in the cycle of addiction, please know there is hope. Part 2 of this blog series will talk about the recovery system. When we as therapists and helpers are able to notice the cycle and work on changing our belief system about addiction, we can work on guiding addicts into recovery to get out of the addictive system all together.
Resources for learning more:
- Facing the Shadows 3rd Ed – by Patrick Carnes, PhD
- Out of the Shadows – by Patrick Carnes, PhD
- Mindsight: The New Science of Personal Transformation – by Dan Siegel, MD
- The Magic – by Rhonda Byrne
- Facing Heartbreak – by Patrick Carnes, PhD
- Courageous Love – by Stefanie Carnes, PhD
Carnes, P. (2015). Facing the shadow: Starting sexual and relationship recovery. Gentle Path Press.