Hooked – knowing our addictions

‘The addiction’s not in the drink or the bet or the drug. The addiction is in my head. It’s an inside job’ – Paul Merson. I spent some of my Christmas break reading the remarkable book Hooked by Merson, the former Arsenal and England footballer. In it he speaks openly about his struggles with addiction, in particular gambling and drinking, and his process of recovery. The suggestion of an ‘inside job’ was particularly poignant, highlighting how addictions are a reflection of what is going on inside us, rather than simply the relationship with our particular ‘drug of choice’. A number of psychologists have highlighted how addiction is a ‘chronic condition’ that involves the compulsive consumption of a substance or behaviour, that has the significant potential of harm to our self and/or other people. Perhaps what is most interesting for many of us is that addiction doesn’t have to simply involve the usual suspects of drugs, alcohol, gambling etc but include anything we can consume. For example, psychiatrist Dr. Amanda Lembke argues that the potential for addiction in modern society is overwhelming whether this is, ‘drugs, food, news, gambling, shopping, gaming, texting, sexting….’. She also suggests that the smartphone is the ‘modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.’ In many ways, in today’s society it is hard not to be ‘hooked’ on something owing to the staggering array of highly rewarding stimuli we encounter daily. 

Dr. Lembke goes on to suggest that one of the reasons we become addicted, and over consume, is we are running from pain. ‘Pain’ in this sense doesn’t simply include physical pain, but emotional pain like sadness, anger or anxiety and also general angst as well through the daily struggles of living. She succinctly suggests that when it comes to addiction, ‘the reason we’re all so miserable may be because we’re working so hard to avoid being miserable’. Specifically, we are self medicating through food or social media to placate some pain, but such ‘medication’ causes more harm than good in the long run. Footballer Paul McGrath, another sports person who has been bravely honest regarding his addictions, highlights this ‘numbing’ element that addiction provides when he says, ‘you see, I drink. I gamble. I fall down. I drink again. It’s a pitiful cycle. A lethal one. Sometimes I go to the amusement arcade and sit for hours at the slot machines, pouring coins in as if by staying long enough something magical might occur. It never does. I don’t do this for the buzz. It’s just the feeling of a compulsion.’ So although addiction is based on the release of the neurotransmitter dopamine, which is associated with the feeling of pleasure, it diminishes over time – in essence you will need more of the same drug to feel that high you did at the beginning. This increase is the ‘compulsion’ Paul McGrath speaks of.

So how do we deal with our own addictions? Dr. Lembke recommends  ‘dopamine fasting’, and uses the acronym of DOPAMINE to help with this process:

  • D stands for Data: understanding the facts of our own compulsion – what is being used, how much and how often.
  • O stands for Objectives: what does the compulsion provide us with, how does it help us function or cope in some way.
  • P stands for Problems: this is a willingness to explore the problems that arise from the substance or behaviour.
  • A stands for Abstinence: this is the fasting part, providing time to explore the cause and effect between the addiction and how we’re feeling.
  • M stands for Mindfulness: this is trying to observe what our brain is doing, while we are doing it, without harsh judgement.
  • I stands for Insight: this is developing an understanding of our behaviours through abstinence. 
  • N stands for Next Steps: what you want to do after a period of taking a break from the drug or behaviour.
  • E stands for Experiment: this is going back into life with a new plan on how to manage the addiction. 

Dr. Lembke’s acronym is useful as it provides a framework for all of us to deal with our compulsive, addictive forming behaviours. For we all have the potential to become addicts. The philosopher Kent Dunnington suggests that, ‘persons with severe addictions are among those contemporary prophets that we ignore to our own demise, for they show us who we truly are.’ Beyond doubt, we should always show compassion for those who have severe addictions, for such compulsion is indiscriminate in who becomes ‘hooked’. 

Worth a read:

Brown, J. L. and R. West (2018). Understanding the psychology and treatment of addictions. Addiction: Psychology & Treatment. P. Davis, R. Patton and S. Jackson. Chicester, John Wiley & Sons Ltd: 3-20.

Lembke, A. (2021). Dopamine Nation: Finding balance in the age of indulgence. London, Headline Publishing.

McGrath, P. and V. Hogan (2006). Back from the brink. London, Century.

Merson, P. and R. Bagchi (2021). Hooked: Addiction and the long road to recovery. London, Headline Publishing.