Is There a Difference Between Physical and Psychological Addiction?

Addiction is often understood as physical dependence on a substance, but the reality of this disease is far more complex.  While the existence of psychological addiction has been acknowledged for some time, these two facets of dependence are often discussed as separate from one another.  Research has repeatedly proven, however, that the physical and psychological effects of behavioral addiction and substance abuse play off each other in intelligent and insidious ways, ensnaring the individual in a destructive cycle.  Recovery from addiction requires a careful assessment of the emotional, mental, and physical relationship that has developed with a substance or behavior. In recent years, successful holistic treatment centers have sought to address all aspects of addiction simultaneously to prevent relapse.

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Understanding Physical Addiction

Before we understood as much about addiction as we do today, the evidence of physical addiction and withdrawal informed the perception of the process of addiction, as well as the recommended treatment.  These withdrawal symptoms were very visible and easy to document for doctors and researchers that witnessed them. Substances like alcohol and opiates created uncontrollable cravings after heavy use. Despite substance abuse often leading to major life consequences, addicted individuals found themselves unable to stop.  When they did attempt to quit, they were faced with severe physical reactions including nausea, shaking, insomnia, chills, and body aches. It was once believed that the fear of withdrawal was the most significant obstacle in the way of recovery and that methods to ease withdrawal symptoms should be the primary focus of treatment.  However, with time and research, we began to understand that addiction happens in the mind as much as in the body. Researchers observed that people who were addicted to substances that did not cause withdrawal symptoms were still unable to quit on their own, and that behavioral addictions were just as powerful as those created by substances.   

Even the physical side of addiction is more complicated than previously thought.  Substances like drugs and alcohol disturb natural dopamine production in the brain, causing a depression-inducing lack of dopamine when the user attempts to quit.  The effects of substance abuse on the brain can persist long after the initial withdrawal symptoms, meaning that physical addiction continues to create obstacles in recovery even after detoxification.  These brain changes can have various mental health implications, which is just one reason that physical addiction is inextricably tied to psychological dependence.

Psychological Addiction to Substances and Behaviors

Despite the fact that the medical community once believed that people struggling with addiction refused to quit only out of fear of withdrawal, the reality is that the emotional and psychological issues that follow addiction are what keep most people using.  Many people who develop addictions struggle with mental illness or the lingering emotional effects of trauma. Unprocessed and suppressed emotions wreak havoc on the psyche, and substances like drugs and alcohol are often used to distract unhappy people from their pain. These preexisting mental health issues and past traumas further complicate the psychological repercussions of substance abuse, adding to the effects of depleted dopamine and serotonin levels in the brain.  

Whether an addiction forms around a substance or behavior, the problem arises when the reward system in the brain is triggered by an act that otherwise causes harm.  Whether an individual is addicted to alcohol or shopping, by repeating the behavior that stimulates their reward system they are flooding their brain with feel-good good chemicals.  These chemicals induce a high, while also teaching the brain to crave that substance or behavior in the future. With this knowledge, it is easier to understand why substance addictions are often replaced by behavioral addictions.  A person who vows to stay sober but doesn’t do the emotional work to address their addictive tendencies may quell those urges with gambling, sex, shopping, etc. to recreate that reward.  

The Physiological Truth

Addiction research continues to confirm the assertion that no addiction can be considered purely physical or purely psychological.  Almost all cases of addiction begin with a combination of psychological factors and physical reactions. Most people who abuse substances are attempting to change their mental state or numb unpleasant emotions, both of which can be remedied with therapy and medical care instead.  For those behavioral addictions that form without the aid of a physically addictive substance, the process of recovery can still cause very concrete physical effects. Additionally, psychological issues are no longer understood to be purely mental. The medical community currently validates body-mind connections that result in measurable experiences of pain and discomfort, such as chest tightness, shortness of breath, and numbness that can occur as a result of anxiety. The more we know about addiction, the clearer it becomes that every individual has a unique experience and specific needs.

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Dear Renewal Lodge Visitors,

My name is John Bruna, co-founder of the Mindfulness in Recovery® Institute, and more importantly, a grateful member of the recovery community. I am incredibly fortunate to have found my recovery in 1984. Of course, I did not achieve continuous recovery through willpower or my own efforts, but through the guidance and caring support of countless others that selflessly taught me how to live through the 12 Steps.

My journey of recovery brought this once homeless, shame-based, traumatized, insecure young man to a life far beyond anything I could have ever imagined. I discovered self-worth, the joy of helping others, the gifts of parenting and grandparenting, and most importantly the ability to live a meaningful and purposeful life with integrity.

One of the greatest gifts of recovery is that I have the opportunity to give back and help others discover their self-worth, dignity, and the skills to fully live lives that they find truly meaningful. This is the inspiration for developing the skills of Mindfulness in Recovery® (MIR) to meet the needs of new generations struggling with alcohol and other substance use disorders. MIR is a set of evidence-based skills designed to help people fully integrate their tools of recovery in ways that are personalized, practical, and in alignment with their deepest values.

While we train counselors and therapists throughout the United States and abroad, I personally have chosen to work directly with the amazing team and clients at Renewal Lodge to develop the model MIR 12-step program for the nation. I choose Renewal Lodge because of the vision of its mission and the dedication of its team. Renewal Lodge is an extremely rare environment in which the staff embodies the very mindfulness and 12-step practices and skills they offer their clients. The results have been beyond my expectations. It is an honor to be here and I treasure my personal time with every client I meet.

With Gratitude,

John Bruna
John Bruna
Director of Mindfulness
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