Can a Behavior be an Addiction?

In a previous blog I asked if someone could be addicted to being at a bar. I presented the example where Bert, a teenager was at a bar named Water Bar in my birth Caribbean village of Trafalgar, Dominica. Bert accused one of the adult men who was waiting outside the bar with him before 7:00am of being an alcoholic. The man did not deny his label but wondered why Bert too was there so early in the morning, and visits the bar so frequently, and for so many hours during the week and on weekends. The man labeled Bert a Waterbaraholic (addict of Water Bar). Bert denied that label claiming, “… a bar is not rum for me to be addicted to it.”

I thought that this example raised a good question about whether a person can be addicted to certain types of behaviors, such as frequently being at a place like a bar. In this visit, we will explore what various mental health professionals have to say on the topic. Is there such a thing as a behavioral addiction? If so, what exactly is it? It will also be important to consider what the general public and counselors should know about behavioral addictions. However, I will leave that topic to future blogs. Here, we will only explore whether behaviors can be addictive. In another future blog, I also aim to explore deeper into what makes a behavior an addiction.

“Historically, the concept of addiction was marked by the loss of control over one’s use of alcohol or another drug of abuse. However, with advances in neuroscience and empirical research, it is now known that addiction can manifest with or without the ingestion of psychoactive chemicals” (Giordano, 2022:1).  Other selected authorities on the idea that addiction is not limited to the injection of chemicals are as follows:

1. American Society of Addiction Medicine (ASAM, 2019): addiction is a disease where compulsive substance use, and/or compulsive behaviors persist regardless of their negative consequences. 
2. Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013):  the chapter titled, “Substance-Related and Addictive Disorders,” identify both behavioral (adding gambling disorder) and chemical addictions. Internet gaming disorder and nonsuicidal self-injury disorder were listed as conditions for further study in Section III, suggesting that other potentially addictive behaviors likely will be added to the DSM in the future (APA, 2013).
3. International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018) includes a section entitled, “Disorders Due to Addictive Behaviours.” It adds gaming disorder and gambling disorder, and the section for impulse control disorders includes compulsive sexual behavior disorder.
4. Council for Accreditation of Counseling and Related Educational Programs [CACREP]) currently requires counseling students to have knowledge about both “addictions and addictive behaviors” (Section 2, F.3.d., CACREP, 2016).
5. For decades, prominent internationally recognized clinicians, such as Claudia Black (family systems work with addictions), William Miller (a developer of motivational interviewing), and others have been raising awareness about behavioral addictions.

Giordano (2022: 2) concludes, “The question is no longer ‘Can behaviors be addictive?’ but rather, ‘How can clinicians best serve clients with behavioral addictions?’ Her book answers that question.

In a future blog, entitled “When Behavior becomes Addiction” I will explain what counselors identify as specific aspects of behaviors that make them addictions. For now, I encourage readers to let this sink in for a moment: the idea that depending on the details surrounding Bert’s frequent socialization at Water Bar, the teenager may or may not have an addiction that requires intervention. For now, the evidence is clear. Bert is wrong; even if Water Bar is not rum (alcohol), be still can be addicted to it. But how; why? We will explore in future blogs.

If you are concerned about having a behavioral addiction, chemical addiction, or are otherwise in need of counseling, please contact me (Peter K. B. St. Jean) at Olive Branch Counselling Associates, (708) 633-8000. We are located at 6819 West 167th Street Tinley Park, IL 60477. You can also visit us at https://www.olivebranchcounselingassociates.com for more details.

Written By: Peter S.J., Masters Level Intern

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

American Society of Addiction Medicine. (2019). Definition of addiction. https://www.asam.org/docs/default-source/quality-science/asam’s-2019-definition-of-addiction-(1).pdf?sfvrsn=b8b64fc2_2

Council for Accreditation of Counseling and Related Educational Programs. (2016). 2016 CACREP standards. www.cacrep.org

Black, C. (2001). It will never happen to me: Growing up with addiction as youngsters, adolescents, adults (2nd ed). Hazelden.

Giordano, A. L. 2022. Treating Behavioral Addictions: A Clinical Guide to Treating Behavioral Addictions. New York: Springer Publishing Company.

Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals (2nd ed.). The Guilford Press.

World Health Organization. (2018). International statistical classification of diseases and related health problems (11th Rev.). https://icd.who.int/browse11/l-m/en