I’ve come across so many theories on what the causes of addiction are. I often get shocked faces when I say that I’m an addict. I have been told things like ‘you don’t look like an addict’. I suppose to many people the word addict brings to mind an image a somewhat lesser person, psychologically compromised in some way, ‘crazy’ and not to be trusted. One key assumption that prevails is that a person has to experience trauma to be affected by addiction.
It has been really illuminating for me to learn over the years that addiction is a brain disease. While it often does get triggered through trauma, be it big traumatic events or smaller traumas (which we all experience), it’s not a prerequisite for addiction to develop. ANYONE can be affected by addiction.
One of my teachers, Bitten Jonsson, a food addiction specialist from Sweden, recently reminded me to not underestimate the power of the drug in the addiction piece. She explained that there was a real trend in the past to look for the underlying psychological causes of addiction in patients. She says that especially in the eating disorders field, the assumption has been that once we’ve dealt with our underlying traumas we’ll be able to eat all foods normally again. Of course this is indeed the case for many emotional eaters where there’s no addiction.
But it has been my personal experience, and that of many others, that the physical cravings set off by the drug itself were what first sparked our emotional and psychological attachment to the drug. And just think for a second: When do we first get exposed to addictive food substances, such as sugar, for example? Age 2, 3, 4? Trauma of course for many of us will have contributed to subsequent increasing dependency on the substance. But by then the substance itself may have already interacted with our brains in a big way!
The addictions specialist Terence Gorski describes addiction as a bio-psycho-social disease. ‘Bio’ means it affects the body; ‘psycho’ means in affects the mind; and ‘social’ it means it affects a person’s relationships with others and the environment. So, what that tells us is that when we’re looking at treating addiction we need to look at all these factors and not only focus on the trauma.
In dealing with food addiction, we absolutely must remove the drug! As long as we are still ingesting our drug, no therapy will work. That’s why working through what an abstinent food plan looks like for us is so important in the beginning. I witnessed many times how people were not getting better despite therapy because they were still ingesting their drug foods and engaging in their compulsive food behaviours. Comparing this to alcohol and heroin helps me a lot. Surely, I wouldn’t be sending an alcoholic who is drunk to start a therapy? Or a heroin addict who’s just had a fix? It’s the same for the food. We need to make all efforts to get abstinent before we can do the real work. Food being a lot trickier than drugs and alcohol, this often takes trial and error. But it’s an essential part of the process.
I was reflecting on why I felt compelled to write about this. From a professional perspective I want to underline the importance of looking at food as the drug and the need for a withdrawal process. But there’s a personal motivation too. Knowing that addiction is a brain disease is empowering. For years I tried different therapies and felt like a real basket case. I took on a lot of the social stigma and was full of shame about being an addict. I assumed I had grave emotional and psychological problems and could not face the world until I had solved them. Because the therapies weren’t solving my addictive eating, I thought I was crazy. Now I know that I just didn’t have the right information or access to the right solution.