1. Abuse (physical, psychological, sexual, and financial)
  2. Anger
  3. Anxiety
  4. Addiction & Compulsions (substance, gambling, internet, sexual, pornography)
  5. Bullying
  6. Communication issues
  7. Depression
  8. Food & Eating Disorders
  9. Family Issues
  10. Grief, loss & bereavement
  11. LGBTQ Issues / Gender Identity, Sexual Orientation
  12. Couples/Relationship Issues
  13. Stress
  14. Suicide/Suicidal ideation/Self Harm
  15. Workplace issues

1. Abuse (physical, psychological, sexual, financial)

Abuse is a misuse of power intended to harm or control another person. The maltreatment can be physical, verbal, or emotional. All types of abuse can cause pain and psychological distress. 

Abuse can leave psychological wounds that are harder to heal than bodily injuries. Survivors of abuse may have intense, negative feelings long after the abuse has ended. Anxiety, flashbacks, and trust issues are common in people who have experienced abuse. Abuse can impact a person’s ability to form relationships and find happiness. 

Yet the effects of abuse do not have to be permanent. Your therapist can help abuse survivors overcome challenges and address symptoms. Therapy can also help those who engage in abuse to stop harmful behaviours, though the individual must truly wish to change.

TYPES OF ABUSE

There are many types of abuse. Abuse can be classified by its form or by its context.

Forms of abuse include:

  • Physical Abuse: When someone deliberately causes physical harm to another. This type could include behaviours such as punching or whipping. It also includes actions which cause illness or disability, such as poisoning. 
  • Sexual Abuse: Any form of sexual contact made without consent. This type may include rape, child molestation, incest, or other acts of sexual violence.
  • Emotional/Psychological Abuse: A chronic pattern of manipulation to control another person. Tactics include verbal attacks, isolation, humiliation, or threats. A person may also use gas lighting to make a target doubt their memories. 
  • Financial Abuse: When someone uses money to gain control over a person. They may take over one’s bank account or steal one’s identity to rack up debt. Selling or taking one’s property without permission also counts as abuse.

Abuse can occur within any kind of relationship, whether familial, professional, or social. It can also occur between strangers, although this pattern tends to be rarer. Common contexts are:

  • Domestic Abuse: Also called intimate partner violence or spousal abuse. Any form of abuse which occurs in an intimate relationship counts as domestic abuse. The relationship can be straight, homosexual, monogamous, polyamorous, and so on.
  • Elder Abuse: When someone harms, exploits, or neglects an elderly person. The abuser is often someone in charge of the elder’s care, such as a family member or nursing home worker. In the U.S., roughly 1 in 10 Americans over age 60 have experienced elder abuse. 
  • Child Abuse: When someone harms, exploits, or neglects a minor under 18. Estimates say one in four American kids have experienced neglect or abuse at some point. 

A person can experience more than one type of abuse. For instance, someone who is psychologically abused may experience physical abuse at the same time. In fact, psychological abuse is often a precursor to physical violence.

References:

  1. Child abuse and neglect: Consequences. (2018, April 10). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/consequences.html
  2. Child abuse statistics & facts. (n.d.) Childhelp. Retrieved from https://www.childhelp.org/child-abuse-statistics
  3. Elder abuse facts. (n.d.) National Council on Aging. Retrieved from https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts
  4. Henning, Kris and Klesges, Lisa M. (2003, August). Prevalence and characteristics of psychological abuse reported by court-involved battered women. Journal of Interpersonal Violence, 18(8), 857-871. Retrieved from http://jiv.sagepub.com/content/18/8/857.full.pdf
  5. McRobbie, L. R. (2014, January 7). The real victims of satanic ritual abuse. Slate. Retrieved from http://www.slate.com/articles/health_and_science/medical_examiner/2014/01/fran_and_dan_keller_freed_two_of_the_last_victims_of_satanic_ritual_abuse.html
  6. Psychological abuse. (n.d.) National Coalition against Domestic Violence. Retrieved from http://www.ncadv.org/files/PsychologicalAbuse.pdf
  7. Rimer, S., & Verhovek, S. H. (1993, May 4). Growing up under Koresh: Cult children tell of abuses. The New York Times.Retrieved from http://www.nytimes.com/1993/05/04/us/growing-up-under-koresh-cult-children-tell-of-abuses.html?pagewanted=all
  8. Society for Research in Child Development. (2014, July 24). Maltreatment affects the way children’s genes are activated. Retrieved from www.sciencedaily.com/releases/2014/07/140724094207.htm
  9. (n.d.) National Coalition Against Domestic Violence. Retrieved from https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts
  10. https://www.goodtherapy.org/learn-about-therapy/issues/abuse

2. Anger

Anger is a strong feeling of displeasure. It is often a reaction to stress, failure, or injustice. Anger can range from mild irritation to full-blown rage.

It is normal to experience anger. At times, anger is the appropriate response to the actions of others. When managed correctly and kept in check, anger can be an important ally to a healthy adult. 

But anger has risks, perhaps more than any other emotion. It can alienate people from others and lead individuals to do things they later regret. People who have lasting, extreme anger may find it helpful to explore its causes with a therapist.

WHAT CAUSES ANGER?

The causes of anger can vary. It may be triggered by external factors such as bullying, humiliation, and loss. Internal factors, such as frustration or failure, can also lead to anger.

Anger is not always a reaction to a present circumstance. Sometimes a situation will unconsciously remind a person of a past experience. A person may displace their anger about the past onto the present situation.

Anger typically has less to do with an event and more with how a person reacts to the event. Certain negative thought patterns often precede an outburst of anger. These patterns include:

  • Blaming: When a person claims negative events or emotions are always someone else’s fault. Blaming others is often an attempt to avoid responsibility or shame.
  • Overgeneralizing: When a person gets caught up in black and white thinking. The words “always” and “never” are common in this pattern. Overgeneralizing often makes a situation seem worse than it really is. 
  • Rigidity: When a person is unable to reconcile what is happening with what they think should happen. The individual may have a low tolerance for frustration.
  • Mind-reading: When a person convinces themselves that another person intentionally hurt or disrespected them. The person may intuit hostility where there isn’t any.
  • Collecting straws: When a person mentally tallies things to justify their anger. They let small incidents build in their head until they reach “the last straw.” The person’s anger then boils over in what most people see as an overreaction. 

By challenging these thought patterns, most people can reduce their anger.

WHAT IS THE POINT OF ANGER?

Anger can help individuals relieve stress by motivating people to solve a problem instead of enduring it. For example, a person caught in a frustrating traffic jam may look for a faster route home. A healthy expression of anger can open up dialogue about negative feelings. In a fight-or-flight scenario, anger can be necessary for survival.

Some people may show anger because they have difficulty expressing other feelings. They may have been taught that certain emotions, such as fear or sadness, are unacceptable. Masking these emotions in the form of anger may work as a defense mechanism. Anger may allow the person to avoid feelings which could damage self-esteem or cause more stress. Yet it can also hide the actual issue at hand, delaying a resolution.

EXPRESSING ANGER

Like many emotions, anger by itself is neither bad nor good. The consequences of anger depend on how a person reacts to the emotion. 

Some people feel that letting their anger out by screaming or yelling at someone else helps them feel better. But angry outbursts can become a habit. Aggression tends to cause more anger, not less. Moreover, the way other people react to anger can fuel an individual’s stress and may lead to increased anger.

Other individuals may express anger through passive aggressive behaviours. Passive aggression is a subtle attempt to change, stop, or punish an action. For example, a teen who is upset that her family ate dinner without her may “forget” to clean the dishes that night. A person may feel passive aggression is a safer or more polite way to get what they want. However, it is more likely to cause confusion than solve the issue.  

Assertiveness is one of the healthiest ways to deal with anger. An assertive person will state what they need in a clear and direct manner. They will try to get their needs met without hurting anyone else. Assertiveness is the middle ground between being pushy and being a pushover.

WHEN ANGER BECOMES A PROBLEM

Anger is a powerful emotion that can influence people’s thought patterns and behaviour choices. It can also cause physical symptoms. An angry person may develop headaches, rapid breathing, or a pounding heart. 

Anger may be a problem when it leads to regular aggression and violence. Someone with anger issues may find themselves constantly yelling or throwing tantrums. They may struggle to enjoy company without getting into an argument. Unchecked aggression can cause social problems. If a person becomes violent, they may also get in legal trouble.

Anger can also be directed toward the self. A person may engage in severe self-criticism to cope with frustration. Over time, they may develop a low self-esteem or even self-hatred. A person may act on this anger in the form of self-harm.

Some people may be aware of their anger issues but not know what to do. The individual may be so overwhelmed with emotion that they feel unable to control it. Such individuals may benefit from anger management therapy. 

GENDER AND ANGER

Research suggests people of all genders experience similar levels of anger. Yet due to socialization, men and women often express their anger differently. 

Men often face stigma for showing sadness or fear. Yet society often labels anger and aggression as masculine. As such, men are more likely to express anger physically, perhaps by throwing objects or hitting people. They are also more likely to act impulsively on their anger.

Women often face stigma for showing anger. Thus, women are less likely to recognize or acknowledge their anger. Some studies suggest they more likely than men to engage in passive aggressive acts. Their bouts of anger tend to last longer.

Gender can also influence the type of anger a person typically possesses. Men are more likely to have a revenge motive around their anger. Women tend to have higher levels of resentment. Women also express more anger directed at themselves. 

ANGER EXPRESSION ACROSS CULTURES

Every culture has display rules about anger. Display rules are social norms about when and how one can express anger appropriately. Research has found trends in display rules among collectivist and individualist cultures. 

Collectivist cultures prioritize cooperation and group cohesion. Their display rules say it is more appropriate to:

  • Conceal one’s anger to maintain harmony in the group. People may mask their anger with another expression or show no emotion at all. 
  • Express anger toward strangers rather than family or friends. People in collectivist cultures often belong to fewer social circles. As such, they tend to be more committed to these groups. Arguments and aggression pose a greater risk for social isolation. 

Individualist cultures encourage independence and self-expression. Their display rules say it is more appropriate to:

  • Tone down one’s expression of anger rather than eliminating it altogether.
  • Express anger toward family and friends rather than strangers. People in individualist cultures tend to move between groups. As such, they may find it more important to get along with people they don’t know yet. They also rely less on any one group for social interaction.

Certain coping mechanisms for anger may be encouraged in one culture and stigmatized in another. Therapists who treat anger issues may need to be mindful of a person’s cultural context. 

ANGER AS A MENTAL HEALTH SYMPTOM

When treating anger, a therapist will likely address underlying diagnoses as well. Anger is closely tied to several mental health conditions, including:

  • Major depression: Anger may be directed at oneself or at others.
  • Bipolar: Irritability is a common feature of mania. Yet a person may also have anger symptoms in their depressive phase.
  • Oppositional defiant behaviour (ODD): An angry or hostile mood is one of the main signs of ODD in children.
  • Narcissistic personality: A person who encounters an insult to their ego may lash out in rage. Anger may mask unconscious feelings of inferiority and fear.
  • Posttraumatic stress (PTSD): People with PTSD often have outbursts of anger with little to no provocation.

People with chronic anger may also be at a higher risk of substance abuse. Drugs and alcohol can help mask anger temporarily. Yet they may also have the effect of worsening one’s anger, as drugs and alcohol can reduce self-control and tend to increase impulsivity.

If you or a loved one has anger issues, therapy can help. A therapist can teach necessary skills to manage overwhelming emotions. They may also help a person address underlying emotions and memories that may be contributing to the distress. With time and patience, anyone can learn to control their anger. 

References:

  1. (n.d.). Retrieved from http://www.apa.org/topics/anger/index.aspx
  2. Controlling anger—Before it controls you. (n.d.). American Psychological Association. Retrieved from http://www.apa.org/topics/anger/control.aspx
  3. Dittman, M. (2003). Anger across the gender divide. Monitor on Psychology, 34(3), 52. Retrieved from http://www.apa.org/monitor/mar03/angeracross.aspx
  4. Matsumoto, D., Yoo, S. H., & Chung, J. (2010). The expression of anger across cultures. In International Handbook of Anger: Constituent and Concomitant Biological, Psychological, and Social Processes(pp. 125-127). New York, NY: Springer.  
  5. Segal, J., & Smith, M. (2015, February 1). Anger Management: Tips and techniques for getting anger under control. Retrieved from http://www.helpguide.org/articles/emotional-health/anger-management.htm
  6. Smith, P. B, Easterbrook, M. J., Celikkol, G. C., Chen, S. X, Ping, H., & Rizwan, M. (2016). Cultural variations in the relationship between anger coping styles, depression and life satisfaction [PDF]. Journal of Cross-Cultural Psychology, 47(3), 441-456. Retrieved from http://sro.sussex.ac.uk/57893/1/__smbhome.uscs.susx.ac.uk_lh89_Desktop_HARVEY___Publications_EASTERBROOK,%20Matt_newangerpaper%20acceptedJCCP10November2015.pdf
  7. (2016.) Anger expression: A study on gender differences [PDF]. International Journal of Indian Psychology, 3(4). Retrieved from http://www.ijip.in/Archive/v3i4/18.01.140.20160304.pdf
  8. https://www.goodtherapy.org/learn-about-therapy/issues/anger

 

3. Anxiety

Anxiety can mean nervousness, worry, or self-doubt. Sometimes, the cause of anxiety is easy to spot, while other times it may not be. Everyone feels some level of anxiety once in a while. But overwhelming, recurring, or “out of nowhere” dread can deeply impact people. When anxiety interferes like this, talking to a therapist can help.  

SIGNS AND SYMPTOMS OF ANXIETY

Diagnosing anxiety depends on a person’s feelings of worry, so symptoms will vary. Personality, co-occurring mental health conditions, and other factors may explain a person’s symptoms.

Anxiety can cause intrusive or obsessive thoughts. A person with anxiety may feel confused or find it hard to concentrate. Feeling restless or frustrated can also be a sign of anxiety. Other people with anxiety may feel depressed.

Symptoms of anxiety can also be physical. Anxiety can cause overly tense muscles, or high blood pressure. Trembling, sweating, a racing heartbeat, dizziness, and insomnia can also come from anxiety. Anxiety may even cause headaches, digestive problems, difficulty breathing, and nausea.

If physical symptoms of anxiety are severe and sudden, it may be a panic attack. 

WHAT DOES ANXIETY LOOK LIKE?

People can show signs of anxiety in many ways. Some may become more talkative, while others withdraw or self-isolate. Even people who seem outgoing, friendly, or fearless can have anxiety. Since anxiety has many symptoms, how it looks for one person is not how it appears for another.

People who have anxiety may be withdrawn, but this is not the case for everyone with anxiety. Sometimes, anxiety may trigger a “fight” rather than “flight” response, in which case a person might appear confrontational. Stumbling over words, trembling, and nervous tics are often associated with anxiety. While they can appear in people with anxiety, they are not always present, and some people who do not have anxiety also show these signs. 

If you are unsure if someone you know may be experiencing anxiety, it may not be helpful to bring it up unless they do. However, there are some actions you can consider taking if you want to make a person who might be anxious more comfortable. You can:

  • Be patient with them
  • Share words of encouragement or appreciation
  • Be predictable and be willing to share details with them if they ask

WHAT DOES GENERALIZED ANXIETY MEAN?

Generalized anxiety is also known as free-floating anxiety. It is identified by chronic feelings of doom and worry that have no direct cause. Many people feel anxious about certain things, like money, job interviews, or dating. But people with free-floating anxiety can feel anxious for no clear reason. Generalized anxiety can also mean feeling too much worry about a particular event.

The Diagnostic and Statistical Manual (DSM-5) identifies generalized anxiety disorder (GAD) as excessive worry that impacts a person on an almost daily basis. It must last 6 months or more and be difficult to control. It must also not be able to be better explained by any other health condition. A person diagnosed with GAD must also show at least three of the following symptoms:

  • Frequent fatigue
  • Restlessness
  • Irritability
  • Difficulty focusing
  • Sleep problems
  • Muscle tension

Many factors can contribute to free-floating anxiety. Living in stressful or abusive environments may be a cause. Sometimes, anxiety becomes a habit. A person used to feeling anxious about an event might keep feeling anxious once it is over. Some psychologists contend that modern life causes free-floating anxiety. According to them, deadlines, fast-paced lifestyles, and keeping up with social media could cause chronic anxiety.

When a person cannot find where their anxiety comes from, therapy can help. Therapy often helps people learn coping skills for dealing with symptoms of anxiety. Skills that help people with chronic anxiety include deep breathing, meditation, exercise, and assertive communication.

WHAT CAUSES ANXIETY?

Anxiety, like the fight, flight, or freeze response, is for survival. It allows people to protect themselves to avoid harm. Sometimes, a person has high levels of anxiety regularly. They may feel helpless in dealing with their symptoms.

Both biology and environment determine if a person will have anxiety. In other words, anxious behaviour can be inherited, learned, or both. For example, research shows that anxious parents are likely to have anxious children. However, parents may also model anxious behaviour. If so, they might instil that same behaviour in their children. Having a stressful upbringing can also increase a person’s chances of having anxiety. This is because anxiety becomes a way to anticipate danger and stay safe.

Anxiety can also develop due to unresolved trauma. Unresolved trauma may leave a person in a heightened state of physiological arousal. When this is the case, certain experiences can reactivate the old trauma. This is common for people with posttraumatic stress (PTSD).

TYPES OF ANXIETY

Anxiety is at the root of many mental health conditions, including panic attacks and phobias. It is often directly related to other conditions, like obsessions and compulsions, PTSD, and depression. In addition to generalized anxiety, the DSM-5 lists the following mental health issues as anxiety disorders:

  • Separation anxiety: Can be characterized by reluctance to leave home or be apart from parents and anxiety when separated from parents. 
  • Selective mutism: Selective mutism means not speaking at all in only some situations. This may cause issues with academic, work, or social success.
  • Panic: Panic disorder is diagnosed by recurring panic attacks, including physical symptoms of anxiety. 
  • Specific phobias: Phobias are fear surrounding a certain object or situation, which the person avoids. 
  • Social anxiety: People with social anxiety feel fear or anxiety in social situations. The fear is often out of proportion to the threat, and people with social anxiety may avoid social situations. 
  • Agoraphobia: Agoraphobia can include fear of being in open or enclosed spaces, leaving one’s house, and being in crowds or using public transportation.
  • Medication/substance-induced anxiety: This condition is diagnosed by anxiety that seems to be directly caused by exposure to certain substances, like caffeine or alcohol. The anxiety could also be caused by a medication.

ANXIETY IN CHILDREN

Children, like adults, can experience anxiety. However, children may show different symptoms than adults. Knowing how to identify anxiety in children can help parents or guardians address it early. Then, parents may decide to find a child therapist or psychologist to help their child learn how to manage it.

If a child feels anxious more often and more intensely than most children their age, they may have some type of anxiety. A child who has anxiety might have difficulty going to school. They may also avoid social events or extracurricular activities, like sports. Some kids with anxiety are behind for their age in areas like making friends or being independent. Anxiety in children may appear as crying, clinging to parents, or tantrums. 

Kids with anxiety may show certain behaviours that mimic obsessions or compulsions. Continual picking or pulling at skin or hair can be an anxious behaviour. They may also show signs of separation anxiety. Signs of separation anxiety include clinging to parents, crying, or refusing to go to school or friend’s houses. Children can also experience generalized anxiety and may not be able to identify why they feel anxious. As children enter adolescence, they may be more likely to develop anxiety. Social anxiety often begins around age 13. Up to 25.1% of adolescents ages 13 to 18 may be affected by an anxiety condition. 

Older children or teens may develop food-related anxiety, which can lead to disordered eating. If left unchecked, this can cause serious health complications. Studies show that up to 91% of female teens have tried to control their weight with food. Meanwhile, around 40% of female teens show signs of disordered eating. Some researchers say that eating issues in males are also increasing. While food-related anxiety can occur on its own, it often co-occurs with other anxiety-related conditions, such as obsessions and compulsions. Disordered eating may also develop in teenagers as a coping mechanism for handling anxiety, stress, or trauma.

References:

  1. American Psychological Association. (2009). APA concise dictionary of psychology. Washington, DC: American Psychological Association.
  2. Anxiety disorders and panic attacks. (n.d.). University of Michigan. Retrieved from https://www.uhs.umich.edu/anxietypanic#help
  3. Anxiety disorders. (2016). Retrieved from http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml
  4. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
  5. Does my child have an anxiety disorder? (n.d.). AnxietyBC. Retrieved from https://www.anxietybc.com/parenting/childhood-anxiety
  6. Facts and statistics. (n.d.). Retrieved from https://adaa.org/about-adaa/press-room/facts-statistics  
  7. Hudson, J. L., Dodd, H. F., & Bovopoulos, N. (2011). Temperament, family environment and anxiety in preschool children. Journal of Abnormal Child Psychology, 39(7), 939-51. doi: http://dx.doi.org/10.1007/s10802-011-9502-x
  8. Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology. Hoboken, NJ: John Wiley & Sons.
  9. Teenage eating disorders. (n.d.). Walden Center for Education and Research. Retrieved from http://www.waldencenter.org/popular-searches/teen-eating-disorders
  10. Tyrer, P., & Baldwin, D. (2006). Generalised anxiety disorder. The Lancet, 368(9553), 2156-66. Retrieved from http://search.proquest.com/docview/199069841?accountid=1229
  11. https://www.goodtherapy.org/learn-about-therapy/issues/anxiety

4. Addictions and Compulsions(substance, gambling, internet, sexual, pornography)

An addiction—a persistent need to consume a substance or commit an act—is distinct from a compulsion, which is an overwhelming and irresistible impulse to act. Usually, a compulsive act is preceded by obsessive, intrusive thoughts that compel the person to act, whereas an addiction is more of a habit that is not necessarily accompanied by obsessive thinking. An individual experiencing either addiction or compulsions may find it helpful to speak to a mental health professional.

IDENTIFYING SIGNS AND SYMPTOMS

Compulsive behaviour’s include chronic gambling, substance abuse, sexual addictions, unrestrained shopping and spending, hoarding, excessive exercising, Internet gaming, eating issues, and other behaviour’s. Any compulsive behaviour can become an addiction when the act is no longer able to be controlled and impairs a person’s ability to function socially, academically, and professionally. The distinction between “addiction” and “compulsion” can sometimes become unclear, as a person might think frequently about the object of the addiction, and it may become near-compulsive to pursue the addictive behaviour.

Determining whether a habitual behaviour has become problematic begins with evaluating the benefits associated with the activity and the feelings and beliefs surrounding it. The distinction between a passionate hobby and a compulsive behaviour may be difficult to discern. For example, is running 10 miles every day—rain, shine, or snowstorm—an addiction, or is it good athletic discipline? Is a monthly trip to Vegas to play the slots a gambling problem, or just an escape from daily life? Addiction or compulsivity may be indicated when the behaviour results in feelings of distress, guilt, or shame or when abstaining from the behaviour provokes anxiety or proves to be impossible.

Symptoms that suggest a compulsive behaviour has become problematic include:

  • Interpersonal and professional relationship problems
  • Concealment of the behaviour
  • Denial of a problem
  • Inability to stop the behaviour
  • Alternating feelings of anxiety, confusion, shame, or elation that revolve around the behaviour
  • Withdrawal from or a lack of enjoyment in other activities
  • Desire only for the company of others who pursue the activity or, to an opposite extreme, the urge to conduct the activity only in isolation
  • Fear surrounding the potential repercussions associated with discontinuing the activity

RELATED CONDITIONS AND CAUSES

Typically, addictions or compulsions develop as a result of an underlying psychological issue, such as depression. Engaging in an act of addictive behaviour can temporarily relieve stress or anxiety for several minutes to several days. Compulsive behaviour’s often trigger the same neurological pathways that specific substances stimulate in the brain of someone with drug addiction, and this cycle of reward can make the activity that much more attractive and addictive.

People with severe mental health conditions, such as bipolar, may experience poor impulse control that can make it difficult or impossible to resist compulsive urges. In addition, a rare side effect associated with dopamine agonist medications—which treat conditions such as ADHD and Parkinson’s—can produce extreme compulsive behaviour’s, even in people who had no such inclinations previously.

ADDICTION’S IMPACT ON THE FAMILY

“Addiction, a merciless, emotionally destructive illness, is a family disease or problem, and it can be easy to underestimate the sometimes covert, but painful, “ripple effects” of addictive behaviours’ that lead to hurt, anger, isolation, depression, and despair,” said Darren Haber, MA, MFT, a California therapist who specializes in the treatment of addictions and compulsions.

Family members of an individual experiencing an addiction can develop high levels of stress, especially when daily routines are interrupted by that individual’s unusual, uncharacteristic, or potentially threatening behaviour. Children living in a family affected by addiction may find it difficult to cope with the anxiety, stress, or emotional overwhelm that may result from the chaos and stress in homes affected by a family member’s addiction or compulsions. Addiction that continues to go untreated may have a traumatizing effect on both children and adults, leading to developmental concerns, difficulty regulating emotions, and relationship difficulties among family members or partners.

“I cannot stress highly enough the importance of each family member getting support. “Adults who grew up with a family member who experienced addiction may have a higher likelihood of experiencing depression, anxiety, relationship issues, or learned helplessness. They may also be more likely to develop an addiction themselves, have difficulties with self-regulation, engage in high-risk behaviour, or re-enact a dangerous or dysfunctional cycle from childhood with their own partners and children.

Parents who experience addiction may come to increasingly rely on their children, placing the child in a parental role, which often has an effect on development and can cause difficulties in relationships later in that child’s life. Individuals experiencing an addiction may also isolate themselves from their families due to guilt, a fear of censure, or denial, among other reasons. This isolation can make family interactions and relationships difficult and may also forestall treatment of the problem.

“I cannot stress highly enough the importance of each family member getting support,” Haber said, encouraging all family members affected by a parent, child, or sibling’s addiction to seek help. “Even if it seems they have the problem, [treatment] is the smart, safe thing to do for yourself. It also sets a good example for your loved one, who may be attracted to the positive changes—including loving but healthy boundaries—he or she sees in you.”

THERAPY FOR ADDICTIONS AND COMPULSIONS

Compulsive behaviours and addictions may provide a person with a sense of power, euphoria, confidence, validation, or other feelings that may otherwise be lacking in their lives. Psychotherapy is designed to help people identify uncomfortable feelings and sources of distress in order to change and grow. People who struggle with compulsivity and addiction are unlikely to conquer those behaviours unless they work to address the underlying causes of their addictive and/or compulsive behaviours, such as trauma, stress, past abuse, and others.

Working with a therapist is one of the most effective treatments for managing compulsive behaviours and addictions, and there are many types of therapy suited to addressing behaviours that a person may want to change. A person is likely to achieve the most benefit from consulting with a therapist who is qualified to address the particular area of addiction or compulsion experienced, as well as the underlying cause of the issue. For example, a person who uses drugs to dull the intensity of posttraumatic stress may benefit from treatment for PTSD as well as drug addiction, but resolving the PTSD may also help significantly with treatment for the addiction. Self-help, support groups, and 12-step programs may also facilitate recovery from addiction and compulsivity.

WHAT IS AN “ADDICTIVE PERSONALITY”?

While it is not uncommon to hear people say they have an “addictive personality,” meaning they believe they become addicted to things easily, this so-called addictive personality is not an actual psychiatric diagnosis, and the idea itself may be something of a myth. Personality is a very complex concept. Each individual’s personality is comprised of many different factors, and scientific research has not yet discovered any shared personality trait that is common among all of those with an addiction. Those who experience addiction display as wide a range of character facets as those who do not experience addiction. 

While there is no single addictive personality, there are some factors, some of them components of personality, which have been proven to correlate with addiction. Research shows that genetic factors play a role in addiction. Scientists estimate that 50% of any person’s likelihood of developing an addiction is determined by their genetic makeup. Environment is also thought to play a significant role: a person who is never exposed to a substance can never try it and thus will be unable to become addicted to it. Impulsivity is another factor can influence the development of an addiction, as people with an addiction tend to also exhibit impulsivity at higher rates.

CASE EXAMPLES

  • Internet addiction: Morgan, 22, is a college student. He spends several hours on the Internet each night, sometimes staying awake until sunrise, which generally causes him to experience difficulty functioning in class the next day. He has friends at school but finds he is isolating himself from them and becoming absorbed in the virtual world of the web. Morgan obsessively plays games and engages in chats, and he does little else with his free time. His social life and grades suffer, but he cannot seem to stop. He reports feeling like he is in a daze and says he is bored and anxious when he is not on the computer. Therapy reveals ambivalence about his major and the ensuing career it implies, as well as homesickness, social anxiety, and perhaps some chemical issues that tend toward depression. At the suggestion of his therapist, Morgan begins to involve friends in computer activities, watching movies with them and playing games in a group. This leads to extended social activities, and Morgan’s confidence improves. Career counselling steers him toward a more fulfilling path, and a few family sessions with his mother and brother uncover old grief that, once resolved, allows a better mood to prevail and socializing to become enjoyable again.
  • Therapy for sex addiction: Daisy, 30, is disturbed by her own promiscuity, which has resulted in an unwanted pregnancy that she chose to terminate, as well as the contraction of sexually transmitted diseases, which were treated and remitted. Daisy is ashamed of her behaviour but continues to meet new partners several times a week and engage in what she calls “totally meaningless sex.” Daisy does not know why she is driven to this behaviour. In therapy, feelings of inadequacy, rooted in the experience of being criticized, abused, and eventually estranged from her parents, are discovered. Daisy realizes she is unsure of her own worth, and after several months discovers healthier ways of building self-esteem, such as rock climbing and excelling at her job. Eventually, she begins dating and after experiencing true intimacy, she is able to abstain from compulsive sexual encounters.

    References:

    1. Brandes, H. (2010, Dec 29). Shopping ’til they drop: Compulsive spending poses danger of addiction. Journal Record. Retrieved from http://search.proquest.com/docview/822335078?accountid=1229
    2. Cohen, M. (2016). Do you have an addictive personality? Retrieved from http://www.webmd.com/mental-health/addiction/features/do-you-have-addictive-personality
    3. Compulsive gambling. (2014). Mayo Clinic. Retrieved from http://www.mayoclinic.org/dotorg/diseases-conditions/compulsive-gambling/basics/definition/con-20023242?footprints=mine
    4. Dayton, T. (n.d.). The set up : Living with addiction. Retrieved from http://www.nacoa.org/pdfs/The Set Up for Social Work Curriculum.pd f
    5. Fong, Timothy. (2006, November). Understanding and managing compulsive sexual behaviors. Psychiatry 3(11). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945841
      Kaufman, E. (2005). Impact of Substance Abuse on Families. In Substance Abuse Treatment and Family Therapy. Rockville, MD: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration.
    6. Szalavitz, M. (2016). The addictive personality isn’t what you think it is. Scientific American. Retrieved from https://www.scientificamerican.com/article/the-addictive-personality-isn-t-what-you-think-it-is
    https://www.goodtherapy.org/learn-about-therapy/issues/addictions-and-compulsions 

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