PART ONE

Is Your Unhealthy Habit Really Dependence?

Your Toxic Compulsion Has “Fellow Travelers”

If you’re old enough you might remember a children’s toy consisting of a board with a series of pegs that a young child wielding a mallet attempted to hammer down. The challenge was that each time a peg got hammered down another one popped up elsewhere on the board. I guess this “whack-a-mole” game was supposed to teach the child patience.

For our purposes the toy provides a metaphor for what can happen when we attempt to treat and recover from one compulsion without recognizing and treating other compulsions existing alongside it, and without keeping an eye open for others that may pop up unexpectedly.

Studies show that most gambling addicts also have a problem with alcohol, and most of these folks simultaneously nurse a smoking habit. Many anorexics and bulimics struggle with sexual compulsions.

Or take obesity, which often results from the eating disorder of binge eating. Persons treated for obesity using gastric surgery will often experience other addictive behaviors subsequently, such as gambling or compulsive spending. This tendency toward addiction seems to be “hardwired” into the brain. (Source: “The obesity epidemic: The role of addiction” Taylor VH, Curtis CM, and Davis C. Can Med Assoc J. 2010 Mar 9;182(4):327–28.)

Experts I spoke with called this phenomenon either a “transfer of addictions” or “addiction interaction.” If you or someone you know is struggling with one of the Seven Toxic Compulsions described in this book, you may see or experience some type of addiction transfer or an intensification of an already existing toxic compulsion.

Most treatment centers don’t like to deal with co-occurring compulsions. The reason is straightforwardly financial. For example, to tell someone coming in for alcohol or drug treatment that they must also stop smoking while in treatment might scare people away, and that would affect profits. But the reality is, when left untreated, co-occurring compulsions trigger high relapse rates for the primary compulsion. So my hope is that this book, with its emphasis on education, will help to change attitudes and approaches common in the treatment industry.

Below are the most common co-occurring compulsions, the addictions that often get linked together. Often during treatment when the psychological surface of one toxic compulsion is scratched others are more clearly revealed. Let’s call them the “fellow travelers.”

To which fellow traveler grouping do you belong?

Even if you think your habit involves just alcohol or some other single compulsion, read through the rest of this book. You may in fact find you’ve gotten yourself involved with a group of “fellow travelers.” You will need to recognize and address all of them eventually if you want a successful long-term recovery.

Just one more thought, one that probably should come with a hazard warning label: It’s dangerous for both your thinking and behavior to swing back and forth between abstinence and using—though nearly every addict thinks they can. If you have this illness, trying to control your use rather than ending it could kill you. Never forget that!

If you have a dependency, as opposed to a nondependent use disorder, can you heal yourself and recover on your own? Dr. Howard Shaffer had this answer: “With alcohol, opioids, and gambling, roughly 5 percent to 15 percent of people can do it on their own, which means your chances are really not very good to do it on your own, but the science shows that it is possible. Most people want to think that they can be the one.”