Risk Factor(s) + Attitude + Dark Feelings + A Trigger = Vulnerability to Addiction

If someone is careful in taking an inventory of risk factors, attitudes, feelings and triggers he or she will have a pretty good idea of what creates the soil in which addiction will grow. Hopefully, the addict will begin to see some of the things that can be done in order to avoid or end an addiction. Given an understanding of how addictions develop, we can take a look at how they operate in the daily life of an addict to see what keeps them going even when the results are disastrous.

Addiction puts people on an emotional roller coaster and affects every aspect of daily life. Once someone is fully addicted, the addictive cycle runs through three repeating phases: (1) periods of non-use in which anticipation of the next use dominates thinking, (2) intoxication—the effect, altered state or high produced by the trigger, and finally (3) the post-use depression. In this way the addiction cycle modifies every part of life: health, emotions, thought and behavior.

The changes that occur in each phase can be very different for different addictives and for different individuals, so it is not possible to fill in the cells in the table above in a way that would apply to all addicts. The Action Phase for a gambler might include physical tension, racing emotions, delusional thinking about the chances of controlling use and over-active behavior such as playing three slots machines at a time. The Action Phase for someone abusing a tranquilizing drug probably include total physical relaxation, an absence of any strong emotions, a decrease in mental activity and slow or retarded behavior.

The intoxication phase, sometimes called the action, is the goal of addictive behavior, but it is a goal that doesn’t last.

Artificially induced physical changes, repeated over and over, can result in serious physical stress and chronic illness. Serious disturbances of any sort in emotions, thinking and behavior eventually make normal living impossible.

The anticipation phase is often called craving. It is a period of planning in which the next episode of use occupies thinking. Huge amounts of time, energy and resources are often spent in planning. As soon as the preferred trigger is available, use begins and results in the altered state called intoxication; this is the high or the action phase. Ordinary cares are forgotten as the addict lives very much in the here and now giving little thought to consequences. The customary dark feelings are lifted and put aside until, as must inevitable happen, the period of use ends because of exhaustion, unconsciousness, financial crisis, incarceration or hospitalization. Next comes rebound depression in which dark feelings return with profound severity. Guilt, self-reproach, anger, thoughts of suicide, fear—all these and more swamp rational thinking during the depression phase. Using an addictive, as it always does, has made the dark feelings even darker.

What can the addict possibly do to end this unbearable period of rebound or post-use depression? Anticipation, of course. Never stopping to seriously consider abstinence, addicts begin to pull their bootstraps recapturing energy and hope by thinking about the next chance to use. The excitement of planning ends the depression, energizes life again and drives the addict on to further use. The vicious cycle repeats again and again, sometimes slowly and sometimes within days or even hours.

The physical and emotional stress of the addictive cycle is enormous and results, over time, in physical and mental disorders. Livers gradually fail, cardiac problems develop, teeth are neglected—it’s a down hill slide that can be ended eventually only by death or abstinence. As the slide continues, the addict may lose family, job, children, self-esteem, financial security, even memory, attention span and impulse control. Of course, thoughts of quitting come often, but in thinking about abstinence the addict can see only unending emotional misery, a cloud of dark feelings that will descend and create a life of permanent misery and craving.

In an earlier note I used the word euphoria to refer to the normal, happy state of mind that can be achieved in the process of simple daily living without using mind altering activities. How this is accomplished in normal life will be the subject of later articles, but I believe it can be accomplished by any determined recovering addict. The advanced addict may experience normal euphoria only briefly during the addictive cycle. There may be a kind of familiar excitement during the anticipation phase that is mistaken for happiness, and again early in a period of use, but these feelings are fleeting and artificial.

As I use the term, hyperphoria is an artificially elevated, giddy, unrealistic altered state in which the addict may be capable of acting like an antisocial personality, popularly known as a psychopath. There is no time for real love, little devotion to duty and inability to think about important events. Behavior is impulsive and without planning. There is no concern for consequences of foolish, impulsive acts. The addict is either oblivious or having fun while others think they are looking at a fool.

Finally, the word hypophoria means the extreme low of mental and physical existence reached after a period of hyperphoria. Of course, everyone experiences periods of elevated, moderate and low excitement, and we all cycle through such times, but except for extreme moments of grief or elation we seldom experience altered states and we do not need to produce them artificially with additives.

Over time, in normal life, moods move comfortably from mild euphoria to a moderate state of relaxation and sometimes through feelings of discouragement and depression. But, most people, growing up, become skillful in managing their moods, and they can be assertive socially without being aggressive. They know when to summon their energies and when it’s time to power down and rest. They know how to talk to themselves and how to tell others they want a break, a time of rest. They have psychological resilience and flexibility, and, if they use intoxicants, they do so with in great moderation. In fact, for many people, any state of intoxication is a negative experience since they resent and fear any lose of control.

In the addicted life style, we see violent swings from artificial hyperphoria to hypophoria with little calm or happy time in between. Permanent damage may result in terms of neurology, cardiac function, physiology and psychology to say nothing of a deteriorating social and financial life.

Beyond the difficult tasks of abstinence lies the even more difficult-looking problem of learning the skills non-addicts use to deal with feelings and events in life. Addiction-free living looks very complex and threatening to the addict, but these same skills are often taken for granted by those who have them. They look easy and obvious to non-vulnerable people.

An abstinence program, of course, will end the addictive cycle, but the addict’s thinking has become narrow so that the choice of getting help may not be an option they can see. When others suggest abstinence or self-help groups, addicts may view this as a plot against them. People wanting to help are seen as interfering, meddlesome and lacking in understanding. In fact, many would-be professional helpers do not understand the addictive cycle because they simply have not spent much time actually talking with and listening to addicts.

The addict is most comfortable in the company of other, similar addicts who will sympathize, encourage further use, and understand what one is going through. The social horizon is increasingly limited. Isolation results, an extreme example of which is street life in which the addict is dependent on others for small change, food and a place to sleep, but in which there are almost no enriching social contacts.

How can such a self-defeating and deadly way of living develop? Whose fault is it and where does responsibility for recovery lie? In the next note I will step back and look at the big picture, at the long term stages of living an addict moves through, stages that can produce vulnerability, addiction and, in many cases, eventual recovery.

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